Autoimmune urticaria
Chronic urticaria is a urticaria that persists for more than six weeks. The diagnosis of chronic idiopathic urticaria is often made by ruling out other possible causes of the disorder. Perhaps, chronic idiopathic urticaria may have an autoimmune genesis in as many as 30-50% of patients. Autoimmune urticaria tends to last longer and often resists routine treatment. Patients with autoimmune urticaria are initially treated in the same way as patients with chronic urticaria. Alternative medications are used later. There is evidence of efficacy of cyclosporin and intravenous immunoglobulin. Single reports show evidence on a short-term effect of plasmapheresis. Experience in treatment of patients with chronic urticaria of proved (or non-proved) autoimmune genesis with hydroxychloroquine, omalizumab, and methotrexate is also reported.