Objective: The aim of this study was to clarify the relationship between cholinergic urticaria and autonomic function.
Methods: Clinical and demographic information of subjects with CU-AIGA consulted to our clinic was summarized retrospectively. Digital blood flow (tissue blood flow, blood volume, and flow velocity) was measured with laser tissue blood flow meter before and after the standing position. Quantitative sudomotor axon reflex test (QSART) was used to measure the sweat volume after administration of acethylcholine by iontophoresis.
Results: All subjects with CU-AIGA failed to restore the digital blood flow after standing position indicating the impaired autonomic nerve abnormality. Results in QSART showed extremely decreased sweat volume after stimulation with acethylcholine. After therapeutic intervention (e.g. antihistamines, chinese herbal medicine, or steroid pulse therapy), improved these evaluation items was observed in some cases accompanied with urticarial symptom improvement.
Conclusion: These results indicated the possible involvement of abnormal autonomic nervous function in cholinergic urticaria. The knowledge of possible causal relationship between CU-AIGA and autonomic nervous function may contribute to formulating the novel therapeutic strategies for this disease.