More evidence suggests an autoimmune reaction to gluten may be the underlying cause of an idiopathic condition: chronic urticaria.
In a study published in Pediatric Allergy and Immunology (Volume 16, Issue 5, p428), Italian scientists found a strong correlation between children suffering from celiac disease and chronic urticaria. They also discovered that a strict gluten-free diet completely eliminated the urticaria symptoms for those diagnosed with celiac disease. The researchers concluded that all children suffering from chronic urticaria (hives) should be screened for celiac disease.
I’d like to point out that the association is with chronic urticaria, not acute urticaria. Acute urticaria and chronic urticaria are largely defined by the amount of time the hives last after initial onset. Acute urticaria lasts less than 6 weeks and chronic urticaria lasts more than 6 weeks. I point this out because too often I people categorize celiac disease as food allergy, which it is not. Acute urticaria is more likely to occur with a wheat allergy or a different allergy altogether.
Urticaria is better known as the hives (and sometimes called nettle). When the immune system causes fluid to leak from small blood vessels in the skin, raised bumps called wheals appear. These wheals can be either red or a dull white, and they’re often surrounded by red, itchy skin. Urticaria is basically a skin rash featuring raised, pinkish bumps. Sometimes these bumps can produce a stinging or burning sensation.
When resulting from an allergic reaction, mast cells in the skin produce chemicals like histamine. Histamine causes the small blood vessels to leak wheal-creating fluids.
While many cases of hives involve an allergic reaction, many cases are also the result of another underlying health problem causing disruptions of the immune system.
Acute urticaria is usually the result of an allergic reaction while chronic urticaria often has either an underlying health cause or is considered idiopathic, which means its origin is unknown. Chronic urticaria often doesn’t respond to oral antihistamines.
As long-time gluten intolerance newsletter subscribers know, I’m not fond of conditions defined as “idiopathic.” I often worry it is a way for doctors to disguise the phrase, “We don’t know.”
Several studies and papers in the past have suggested that as much as 40% of all chronic urticaria cases are a result of some kind of underlying autoimmune condition.
This is purely conjecture on my part, but I have wondered if research will eventually reveal a non-celiac gluten sensitivity as the real origin of many so-called “idiopathic” cases of chronic urticaria.
Please note that chronic urticaria is very different from dermatitis herpetiformis, a common skin manifestation of celiac disease.