Chronic Spontaneous Urticaria: A Closer Look at Antinuclear Antibodies and Their Autoimmune Implications

Autoimmune activities in chronic spontaneous urticaria (CSU) are claimed to be one of the most common causes of disease pathogenesis. This study aims to evaluate the prevalence and patterns of antinuclear antibodies (ANA) in patients with CSU, investigate the relationship between ANA positivity and autologous serum skin test (ASST) results, and explore the implications of these findings for understanding the potential autoimmune nature of CSU, particularly in relation to immunoglobulin E (IgE) levels. We analyzed data from 60 patients with CSU at Jahad Daneshgahi Clinic, Tehran, Iran. Patients were categorized based on ASST results (30 positive and 30 negative). Laboratory evaluations included ANAs via indirect immunofluorescence using the HEp-20-10 biochip kit. Data analysis was performed using chi-square and Mann-Whitney U tests. Among the 60 CSU patients, 37 were ANA-positive, with common patterns being nuclear fine-speckled and nucleolar. A decrease in IgE levels among ANA-positive patients compared to ANA-negative ones was also observed. Our study uncovered a notable 61.6% prevalence of ANA positivity among CSU patients, exceeding previously reported rates. The identification of nuclear fine-speckled and punctate nucleolar patterns may indicate associations with specific autoimmune conditions that warrant further investigation. Additionally, the observed lower IgE levels in ANA-positive patients suggest a distinct immunological profile, potentially reflecting type IIb autoimmunity.