Chronic urticaria associated with lung adenocarcinoma - a paraneoplastic manifestation: A case report and literature review.

Autor:	Jiménez LF; Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia., Castellón EA; Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia., Marenco JD; Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia., Mejía JM; Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia., Rojas CA; Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia., Jiménez FT; Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia., Coronell L; Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia., Osorio-Llanes E; Faculty of Exact and Natural Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia., Mendoza-Torres E; Faculty of Health Sciences, Universidad Libre De Colombia, Seccional Barranquilla, Barranquilla 08000, Atlántico, Colombia. evelyn.mendozat@unilibre.edu.co.
Jazyk:	angličtina
Zdroj:	World journal of clinical cases [World J Clin Cases] 2022 Jul 26; Vol. 10 (21), pp. 7553-7564.
DOI:	10.12998/wjcc.v10.i21.7553
Abstrakt:	Background: Urticaria is one of the most common causes of emergency room visits. It is defined as an acute inflammatory dermatosis, characterized by localized degranulation of mast cells, with consequent dermal microvascular and formation of edematous and pruritic plaques called hives. Urticaria affects the skin and tissues of the superficial mucosa. Sometimes it is accompanied by angioedema, which is characterized by deeper edema of the dermis and subcutaneous cellular tissue known as the urticarial-angioedema syndrome. About 15%-25% of the general population has suffered at least one type of urticaria at some point during their lifetime and hyperpermeability estimated at 7.6%-16% and has experienced acute urticaria that is usually self-limited and spontaneously resolves without requiring medical attention. Case Summary: We present the case of a young male patient who was referred to our department with a clinical picture of 4 mo of pruritus associated with hives of variable sizes, irregular borders, with interlesional confluence, that were non-painful, without involvement of the palms and soles of the feet but with a tendency to progression in a generalized manner. He had multiple emergency room visits and poor response to antihistamines and systemic corticosteroids. Imaging studies demonstrated nodules in the lower lingula segment, at the level of the greater fissure and in the anterior contour of the left anterior basal segment associated with parahiliar adenopathies in the absence of findings suggestive of infectious or autoimmune etiology. Segmental lobectomy was performed by thoracoscopy with resection of a lung nodule in the lingula and biopsy of the para-aortic mediastinal ganglion. The histopathological report showed the presence of poorly differentiated invasive adenocarcinoma with a solid morphological and acinar pattern with immunohistochemical description of lung tissue that expresses strong positive and diffuse reaction for thyroid transcription factor 1 (TTF-1) with negativity to P40 for a histopathological diagnosis of malignant epithelial neoplasia with expression of infiltrating adenocarcinoma. Spontaneous chronic urticaria is considered possibly secondary to lung adenocarcinoma. Conclusion: Chronic spontaneous urticaria is considered a paraneoplastic dermatosis with a controversial association in the literature. In the presented case, a young patient presented with chronic refractory urticaria and after an exhaustive clinical work-up was found to have a diagnosis of poorly differentiated lung adenocarcinoma with high expression of TTF-1. According to the Curth criteria, the urticaria presented by the patient is related to the oncological diagnosis. In addition, the high expression of TTF-1 documented in this case could be acting as an autoantigen that would cause chronic spontaneous urticaria. Further research evaluating a causal relationship between the TFF-1 protein and urticaria in lung cancer is needed. Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare. (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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