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  • Title: [Urticaria paradoxically aggraved by H1 antihistamines].
    Author: Catelain A, Freymond N, Queuille E, Nicolas JF.
    Journal: Ann Dermatol Venereol; 2004 May; 131(5):451-3. PubMed ID: 15235532.
    Abstract:
    BACKGROUND: H1 antihistamines (anti-H1) are the treatment of choice in chronic urticaria. We report five cases of urticaria, induced or aggravated by H1 antihistamines. METHODS: The immunoallergological investigations included prick-tests and intradermal tests with the antihistamine responsible for acute urticaria. RESULTS: The skin tests confirmed the non-IgE dependent nature of the urticarial eruptions and anti-leukotrienes (montelukast, Singulair) were effective in controlling chronic urticaria in 3/4 patients. DISCUSSION: Two hypotheses are discussed to explain the paradoxical aggravating effect of H1 antihistamines on the urticaria: 1) the patients are sensitive to the toxic, pro-inflammatory effect of the drug, which is the source of nonspecific activation of mast cells; 2) the fact that the urticaria is sensitive to anti-leukotrienes suggests that histamine is not the principal mediator of urticaria in these patients.
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