The Itch: Allergies, Asthma, Eczema & Immunology18 Sep 2025

#128 - Is Chronic Spontaneous Urticaria an Autoimmune Disease?

When people get hives or swelling, they often think it’s caused by an allergy. But in the case of chronic spontaneous urticaria (CSU), the culprit is often your own immune system. CSU isn’t your typical allergic reaction, instead, it’s frequently an autoimmune condition, where the immune system misfires and activates mast cells without any external trigger.

In this episode, Dr. Payel Gupta and Kortney unpack what it means for CSU to be autoimmune and autoallergic. They explain how IgE and IgG antibodies can trigger histamine release, leading to hives and swelling. You’ll also learn why allergy testing isn’t useful for diagnosing CSU, and how tests like IgG food sensitivity panels can do more harm than good by leading to unnecessary food avoidance and confusion.

What we cover in our episode about autoimmune CSU and chronic hives:

Is CSU an allergy? Why CSU is often mistaken for an allergic reaction—and why standard allergy tests rarely provide helpful answers.
How the immune system works in CSU: What mast cells are, how they release histamine, and their central role in chronic spontaneous urticaria.
Understanding autoimmune CSU: Learn how the immune system can trigger hives from within, including the roles of IgE and IgG antibodies.
Autoimmune hives explained: We explore how CSU can be autoimmune, why the immune system may attack itself, and what Type I and Type IIb autoimmune CSU really mean.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Novartis for sponsoring today’s episode.

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

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