Chronic urticaria is a common heterogeneous condition that can be quite debilitating.
80-90% of patients with chronic urticaria have no specific cause for their disease, which is therefore labeled “chronic idiopathic urticaria.”
30-50% of idiopathic cases may be autoimmune or related to mast cell and basophil abnormalities.
An autoantibody to the high-affinity receptor for IgE (FcepsilonRI) binding to the alpha-chain (FcepsilonRIalpha) may be pathogenic of chronic autoimmune urticaria.
Role of IgE and mast cells in allergy. Image source: Wikipedia.
The gold standard for detecting autoantibodies to FcepislonRI is the functional in-vitro donor basophil histamine release assay.
The spectrum of chronic urticaria. Najib, Umer1; Sheikh, Javed. Allergy Asthma Proc. 2009 Jan-Feb;30(1):1-10.
Autoantibodies to the High-affinity IgE Receptor in Chronic Urticaria: How Important Are They? Medscape, 2005.