When the Immune System Triggers Chronic Urticaria
Autoimmune hives is a form of chronic urticaria in which the immune system mistakenly activates mast cells in the skin. Researchers estimate that a sizeable share of people with chronic spontaneous urticaria have an autoimmune component, although the exact numbers vary between studies.
How the Immune System Triggers Hives
Two main mechanisms are described: antibodies directed against the high-affinity IgE receptor or IgE itself, and IgE directed against the body’s own proteins. Either can cause mast cells to release histamine without any outside allergen.
Autoimmune Conditions Linked to Hives
- Hashimoto thyroiditis and Graves disease. See thyroid and hives
- Type 1 diabetes
- Celiac disease
- Lupus. See lupus hives
- Rheumatoid arthritis
Tests Doctors May Order
Basic blood count, inflammation markers, thyroid function and thyroid antibodies are common. Specialized autoimmune testing is not routinely needed and does not usually change treatment.
Treatment
Treatment follows the standard stepwise approach for chronic spontaneous urticaria. Autoimmune features are sometimes associated with more severe disease and slower response to antihistamines, so earlier add-on therapy may be discussed.
When to Call 911
Go to the emergency room or call 911 immediately if hives are accompanied by difficulty breathing, wheezing, throat tightness, swelling of the lips, tongue or face, light-headedness or a sense that something is seriously wrong. These are warning signs of anaphylaxis.
When to See a Doctor
See a doctor if your symptoms last more than a few days, keep coming back, cover large areas, or interfere with sleep or daily life. The Hives Treatment Center, founded by Dr. Tiffany Young, is a San Francisco practice that evaluates and treats autoimmune hives in person and online.
Frequently Asked Questions About Autoimmune Hives
Does autoimmune hives mean I have lupus?
Not usually. Most people with chronic hives do not have lupus.
Can thyroid treatment clear hives?
In some cases it helps, but results vary.
Is autoimmune hives permanent?
Many people eventually go into remission, though it can take years.
Get Relief for Your Hives
Understanding the immune cause can guide a more effective plan. Visit our hives treatment page to see the latest treatment options for your outbreak.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. If you think you are having a medical emergency, call 911.
