ORIGINAL ARTICLE

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

Made Wardhana , Nyoman Suryawati, Ariana Ariana

Made Wardhana
Departement of Dermatology and Venereology, Udayana Medical Faculty/Sanglah General Hospital, Denpasar, Bali. Email: [email protected]

Nyoman Suryawati
Departement of Dermatology and Venereology, Udayana Medical Faculty/Sanglah General Hospital, Denpasar, Bali

Ariana Ariana
Departement of Dermatology and Venereology, Udayana Medical Faculty/Sanglah General Hospital, Denpasar, Bali
Online First: March 08, 2017 | Cite this Article
Wardhana, M., Suryawati, N., Ariana, A. 2017. The effect of psychological stress on c-reactive protein and peripheral blood cells count in chronic idiopathic urticaria. Bali Medical Journal 6(1): 198-203. DOI:10.15562/bmj.v6i1.407


Background:Urticaria is a vascular reaction of the skin marked by the transient appearance of smooth, slightly elevated papules or plaques (wheals) that are erythematous and that are often attended by severe pruritus. Chronic idiopathic urticaria (CIU)is  the common type of chronic urticaria with no obvious causes, at least some findings suggest that psychosocial factors likely contribute to the development and exacerbation of CIU. The purpose of this study was to investigate the clinical features of CIU and role of psychological stress, C-reactive protein and peripheral blood counts

Methods: The research was designed as a case-control study. The case group was chronic idiopathic urticaria and control group was acute urticaria. The study subject was patients in the outpatient clinic of Dermatology Department, Sanglah Hospital’s, and aged 14 – 60 years old. Urticaria was diagnosed based on distinctive clinical features. To measure the psychological stress level, a structured interview based on Holmes-Rahe stress scale test was applied. The number of basophil, eosinophil, and neutrophil were also counted.

Results:  52 research subjects were recruited which consisted of 25 patients (48.1%) with CIUin the case group and 27 patients (51.9%) with acute urticaria as control group. Family and atopic history did not correlate significantly as the triggering factor, where as environment orinhalant allergens correlated significantly. Stress was found as a significant risk factor, 17 cases (32.6%) of the 52 subjects had psychological stress, the odds ratio was 5.04 (CI 95%; 1.5 – 16.4). There was positive correlation between stress index and total lesion of CIU, R2 = 0.086. Similarly, C-RP level was also positively correlated with the stress index and total lesion of CIU. 

Conclusion:  32.6% of CIU was influenced by psychological stress with odds ratio = 5.04. Basophil was lower in chronic urticaria than in acute urticaria

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