Chronic spontaneous urticaria due to auto-reactivity is defined by the presence of circulating mast cell activating signals. In some, but not all patients with chronic spontaneous urticaria due to auto-reactivity these mast cell activators appear to be autoantibodies directed against the high affinity IgE receptor or against IgE itself. Chronic spontaneous urticaria due to auto-reactivity is diagnosed by use of the Autologous Serum Skin Test (ASST). Detailed recommendations on how to perform and assess the
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