The persistence of chronic spontaneous urticaria in childhood is associated with the urticaria activity score

Background: There is little information regarding the etiology and natural course of chronic spontaneous urticaria (CSU) in childhood. Objective: To investigate the etiology, prognosis, and the factors associated with the prognosis of CSU in children. Method: Data from children with CSU who had been...

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Veröffentlicht in:Allergy and asthma proceedings 2017-03, Vol.38 (2), p.136-142
Hauptverfasser: Arik Yilmaz, Ebru, Karaatmaca, Betul, Cetinkaya, Pinar Gur, Soyer, Ozge, Sekerel, Bulent E., Sahiner, Umit Murat
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Sprache:eng
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Zusammenfassung:Background: There is little information regarding the etiology and natural course of chronic spontaneous urticaria (CSU) in childhood. Objective: To investigate the etiology, prognosis, and the factors associated with the prognosis of CSU in children. Method: Data from children with CSU who had been diagnosed between 1992 and 2015 were analyzed. A telephone interview was done to assess the current status of these patients. Remission was defined as the disappearance of urticaria for >6 months. Results: A total of 222 children with CSU were evaluated. The median age of symptom onset was 8.8 years (interquartile range [IQR], 4.6-12.3 years), median duration of urticaria was 23 months (IQR, 7-48 months), and the median sum of the daily urticaria activity score of 7 consecutive days (UAS7) was 28 (IQR, 21-42). Accompanying angioedema was reported by 107 patients (48.2%), whereas 27.1% of the study population had autoantibody positivity. Autologous serum skin testing results were positive in 43 (34.1%); skin-prick testing results revealed atopy in 55 children (27.9%). Parasites (4.8%), pollen sensitization (1.5%), food allergy (0.9%), urinary tract infection (0.9%), and Hashimoto thyroiditis (0.5%) were determined as etiologic factors of CSU. The patients were followed up for a median time of 15 months (IQR, 5-36.5 months). Remission was observed in 10.6, 29.3, and 44.5% of the patients in 1, 3, and 5 years, respectively. In multivariate regression analysis, a UAS7 of >28 at admission was found to be a risk factor for persistence of urticaria (odds ratio 6.22 [95% confidence interval, 1.54-25.15; p = 0.010). Conclusion: The etiology of CSU in children was mostly idiopathic despite detailed investigation. In childhood, the natural course of CSU was favorable, and nearly half of the patients recovered after 5 years of disease duration. A high UAS7 at admission seemed to be a significant risk factor for the persistence of symptoms.
ISSN:1088-5412
1539-6304
DOI:10.2500/aap.2017.38.4029