Efficacy of Helicobacter pylori eradication on recovery of chronic urticaria

Introduction: The studies have been equivocal about the association of Helicobacter pylori infection with chronic urticaria (CU) given some controversial evidence in recovery of urticaria following H. pylori eradication.

Methods: In this clinical trial, 120 patients between the ages of 4 and 20 with intractable CU were recruited. They were grouped into two categories based on urea breath test (UBT) result. UBT positive group received treatment and UBT was repeated after two months while being evaluated for clinical course over a six-month period. On the other hand, UBT negative group received standard treatment for urticaria.

Results: All participants with CU have been studied as 40 cases of UBT positive and 80 cases of control group with negative UBT, consisted of 42 (35%) male and 78 (65%) female. Patients had suffered from urticaria on average 29.9 (±26.6) months prior to diagnosis. Statistically significant difference was noted between two groups, in terms of severity of urticaria, frequency of episodes, abdominal pain and duration of being symptomatic prior to diagnosis. After receiving treatment for H. pylori infection, among case group, 27(67.5%) of individuals achieved complete recovery of urticaria and 13 (32.5%) cases demonstrated partial resolution of urticaria, meanwhile 59 cases (73.8%) of control group became completely symptom-free, while 21 (26.3%) of the remaining individuals were in incomplete recovery. In comparison of response to treatment between the above-mentioned groups, there was not any statistically significant difference (P=0.47)

Conclusion: Our findings reveal that H. pylori infection might contribute to developing CU which highlights the significance of H. pylori eradication as an approach for CU.