Evaluation of D-dimer levels as a marker of chronic refractory urticaria and its correlation with disease severity

: Chronic idiopathic urticaria (CIU) is very well managed by second-generation antihistamines in the majority of the cases but in a certain subset of patients symptoms persist despite their use. A deeper dig into disease pathogenesis will open new treatment options and better patient management. To evaluate D-Dimer as an anti-histaminic resistant chronic urticaria marker and its correlation with disease severity. Forty chronic urticaria patients attending skin OPD were enrolled and divided into 2 groups of 20 patients each according to response to antihistamines. D-dimer levels were done in each patient. Unpaired t-test was used for assessing two groups and Pearsons correlation coefficient was used to find correlation between D-Dimer levels and Urticaria activity score over 7 days (UAS-7).Result- D-dimer levels were significantly higher in group 1(chronic refractory urticaria) as compared to group 2(chronic urticaria) and there is a positive correlation between D-dimer levels and urticaria activity score (UAS7). Newer insights into alternative pathomechanism of chronic urticaria will open up new treatment options for treatment-resistant cases, this will lead to better patient management and improvement in quality of life.