Prevalence of sensitization to food and inhalant allergens in patientswith chronic urticaria

This study aimed to assess the prevalence of atopy in patients diagnosed with chronic urticaria and to examine its associations with demographic characteristics, laboratory parameters, and immunological markers. The role of atopic responses and allergen sensitivities in the pathogenesis and clinical course of chronic urticaria remains a matter of ongoing debate. Therefore, this study was conducted to evaluate sensitization to both inhalant and food allergens and to investigate its correlation with immunologic profiles, providing a more comprehensive perspective than previous reports. A total of 157 patients who presented to the allergy and immunology outpatient clinic of a university hospital between 2022 and 2025, were diagnosed with chronic urticaria, and had undergone allergen panel testing, were included in the study. The mean age of the participants was 40.88 years. Atopy was detected in 43.9% of patients. There was no statistically significant difference in the prevalence of atopy between sexes. A significant association was found between ANA (antinuclear antibody) positivity and atopy. Among ANA-positive individuals, 61.1% were atopic, compared to 35.7% of ANA-negative individuals. In contrast, anti-TPO levels showed no significant association with atopy. Alatop panel results indicated that increased allergen sensitivity was significantly associated with higher rates of atopy. Among patients with a positive Alatop result, 75% were atopic, while this rate rose to 96% in those with borderline positivity. These findings suggest that sensitization to both inhalant (e.g., mites, pollen, molds) and food allergens (e.g., milk, egg, olive) plays a significant role in triggering atopic responses in patients with chronic urticaria. Although total IgE levels were higher in atopic individuals, the difference was only borderline statistically significant. Other laboratory parameters 26 (including CRP, eosinophil count, basophil count, sedimentation rate, D- dimer, and IgA) did not differ significantly between atopic and non-atopic patients. These results imply that systemic inflammation may not be a dominant feature in the atopic subgroup of chronic urticaria patients. In conclusion, this study demonstrates that atopy is commonly observed in patients with chronic urticaria and is particularly associated with ANA positivity and heightened allergen sensitivity. The findings underscore the importance of evaluating both food and inhalant allergens, and support the integration of immunological markers into routine clinical assessment of atopic patients. The broad allergen screening and inclusion of autoimmune parameters distinguish this study from many others in the literature.