The effect of psychological stress on c-reactive protein and peripheral blood cells count in chronic idiopathic urticaria

Background: Chronic idiopathic urticaria (CIU) is the most common type of chronic urticaria. Studies suggested that psychosocial factors have a role in the development and exacerbation of CIU. This study was carried out to investigate the correlation of psychological stress, C-reactive protein (CRP) and peripheral blood counts with CIU. Methods: This was a case-control study. The study participants were patients aged 14 to 65 years old at the Dermatology outpatient clinic in Sanglah Hospital. The case group consisted of CIU patients and the control group consisted of acute urticaria patients. A structured interview based on Holmes-Rahe stress scale was used to assess the psychological stress level. Blood samples were also collected from the subjects, to obtain the blood cells count and CRP level. The severity was assessed by using urticaria activity score (UAS). Results: Fifty two patients participated in this study; 25 patients with CIU and 27 patients with acute urticaria. Stress was found to be a significant risk factor (OR = 5.04; CI 95%: 1.5-16.4). There was a positive correlation between stress index and the severity of CIU lesion (R2 = 0.086). The mean basophil count of case group was 0.21×103±0.15×103/μL, lower than the control group (p 0.05). While mean stress index and mean blood level CRP of the case group were 146.6±19.1% and 5.5±3.25 mg/dL, respectively. The differences between case group and control group were found to be significant (p 0.05). Conclusion: Psychological stress was a risk factor of CIU, which gave risk for having CIU 5.04 times higher than the control group. The mean basophil count is lower in CIU, while the mean stress index and CRP level are higher in CIU.