Chronic spontaneous urticaria (CSU) is defined as the presence of urticaria for over 6 weeks and is distinct from the inducible (physical) urticarias. Angioedema is seen in 40% of patients as well as dermatographism and delayed pressure urticaria.1 There is no exogenous stimulus, but it is strongly associated with autoimmunity. About 40% of patients have IgG antibody to the IgE receptor (or IgE, itself),2 25% have IgG antithyroid antibodies and 30% a positive ANA. As a group, mean IgE levels are elevated as is specific IgE to a host of possible autoantigens.3 When serum of patients is injected into skin (the autologous skin test), hive formation is seen (when positive) without adding antigen and reflects IgG anti-IgE receptor rather than IgE antibody. There is no diagnostic test for CSU so one has to exclude other entities.4 Figure 1 lists diagnoses (left) and tests or criteria for

中文翻译：

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慢性自发性荨麻疹的诊治

慢性自发性荨麻疹 (CSU) 被定义为荨麻疹存在超过 6 周，与诱导性（物理性）荨麻疹不同。40% 的患者可见血管性水肿以及皮肤划痕症和迟发性压力性荨麻疹。1 没有外源性刺激，但与自身免疫密切相关。大约 40% 的患者具有针对 IgE 受体（或 IgE，本身）的 IgG 抗体，2 25% 具有 IgG 抗甲状腺抗体，30% 为阳性 ANA。作为一个群体，平均 IgE 水平升高，以及针对许多可能的自身抗原的特异性 IgE。3 当患者的血清注射到皮肤中时（自体皮肤试验），在不添加抗原的情况下观察到蜂巢形成（阳性时）并反映 IgG抗 IgE 受体而不是 IgE 抗体。没有针对 CSU 的诊断测试，因此必须排除其他实体。