Schoepke N, et al. - Via performing this multinational, multicenter study of 182 chronic spontaneous urticaria (CSU) patients, researchers sought to better describe the clinical and immunological features of aiCSU and to investigate its potential biomarkers. Positive autologous serum skin test was evident in 107 (59%), positive basophil reactivity was noted in 46 (25%) and IgG-anti-FcεRI+/IgE+ was noted in 105 (58%). All three criteria of aiCSU were fulfilled by 15 patients (8%). Despite appearing more severe (UAS7 21 vs 9), aiCSU patients showed no other clinical or demographic differences from non-aiCSU patients. Also, markedly lower total IgE levels and higher IgG-anti-TPO levels were observed in aiCSU patients. As per findings, aiCSU occurs relatively less frequently but is an immunologically distinct subtype of CSU that cannot be identified by routine clinical parameters. They suggest a possible utility of inclusion of BHRA or BAT in the diagnostic workup of CSU patients for recognizing aiCSU patients, who may have a different prognosis and benefit from specific management.