Allergy Asthma Respir Dis.  2017 Jul;5(4):211-216. 10.4168/aard.2017.5.4.211.

Factors associated with the treatment of chronic spontaneous urticaria in children

Affiliations
  • 1Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea. jina1477@dau.ac.kr
  • 2Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea.

Abstract

PURPOSE
Chronic spontaneous urticaria (CSU) in children is a common skin disorder, but its clinical course varies. We investigated the clinical course and associated factors for CSU treatment in children.
METHODS
A total of 107 children, diagnosed with CSU from 2001 to 2016 in Dong-A University Hospital, who had been followed up for more than 6 months after treatment, were enrolled. The laboratory findings, and clinical aspects and courses were retrospectively investigated by a medical record review. We divided the 152 patients into 3 groups according to the treatment modalities: group 1, 1 antihistamine; group 2, more than 2 kinds of antihistamines; and group 3, antihistamines plus leukotriene receptor antagonist.
RESULTS
The mean age of patients in group 3 was 3.4 years (range, 2.6-4.2 years), which was significantly lower than those at the other 2 group patients (P=0.01). The urticaria activity score (UAS) of group 3 (6.1 [5.7-6.6]) was significantly higher compared to those of the other 2 groups (P=0.01). The improvement rate of the condition in children with positive specific immunoglobulin E (sIgE) reactivity to food or inhalant allergens was significantly lower than that of children with negative sIgE reactivity (P=0.01). Sex, age, history of allergic diseases, disease duration, UAS, previous treatment, and treatment modality were not correlated with the symptom improvement rate.
CONCLUSION
Younger children and those with higher UAS needed more medication to ensure the improvement in symptoms. Moreover, it took more time for the improvement in symptoms in children who were sensitized to food or inhalant allergens.

Keyword

Urticaria; Child; Allergens

MeSH Terms

Allergens
Child*
Histamine Antagonists
Humans
Immunoglobulin E
Immunoglobulins
Medical Records
Receptors, Leukotriene
Retrospective Studies
Skin
Urticaria*
Allergens
Histamine Antagonists
Immunoglobulin E
Immunoglobulins
Receptors, Leukotriene

Reference

1. Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014; 69:868–87.
2. Yu J. Chronic urticaria in children. Allergy Asthma Respir Dis. 2014; 2:236–42.
Article
3. Marrouche N, Grattan C. Childhood urticaria. Curr Opin Allergy Clin Immunol. 2012; 12:485–90.
Article
4. Leech S, Grattan C, Lloyd K, Deacock S, Williams L, Langford A, et al. The RCPCH care pathway for children with urticaria, angio-oedema or mastocytosis: an evidence and consensus based national approach. Arch Dis Child. 2011; 96(Suppl 2):i34–7.
Article
5. Kaplan AP. Clinical practice. Chronic urticaria and angioedema. N Engl J Med. 2002; 346:175–9.
6. Sahiner UM, Civelek E, Tuncer A, Yavuz ST, Karabulut E, Sackesen C, et al. Chronic urticaria: etiology and natural course in children. Int Arch Allergy Immunol. 2011; 156:224–30.
Article
7. Kilic G, Guler N, Suleyman A, Tamay Z. Chronic urticaria and autoimmunity in children. Pediatr Allergy Immunol. 2010; 21:837–42.
Article
8. Dalal I, Levine A, Somekh E, Mizrahi A, Hanukoglu A. Chronic urticaria in children: expanding the "autoimmune kaleidoscope". Pediatrics. 2000; 106:1139–41.
Article
9. Levy Y, Segal N, Weintrob N, Danon YL. Chronic urticaria: association with thyroid autoimmunity. Arch Dis Child. 2003; 88:517–9.
Article
10. Młynek A, Zalewska-Janowska A, Martus P, Staubach P, Zuberbier T, Maurer M. How to assess disease activity in patients with chronic urticaria? Allergy. 2008; 63:777–80.
Article
11. Kelso JM, Sodhi N, Gosselin VA, Yunginger JW. Diagnostic performance characteristics of the standard Phadebas RAST, modified RAST, and pharmacia CAP system versus skin testing. Ann Allergy. 1991; 67:511–4.
12. Zuberbier T, Greaves MW, Juhlin L, Merk H, Stingl G, Henz BM. Management of urticaria: a consensus report. J Investig Dermatol Symp Proc. 2001; 6:128–31.
Article
13. Zuberbier T, Bindslev-Jensen C, Canonica W, Grattan CE, Greaves MW, Henz BM, et al. EAACI/GA2LEN/EDF guideline: management of urticaria. Allergy. 2006; 61:321–31.
Article
14. Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau AM, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. 2009; 64:1427–43.
15. Hiragun M, Hiragun T, Mihara S, Akita T, Tanaka J, Hide M. Prognosis of chronic spontaneous urticaria in 117 patients not controlled by a standard dose of antihistamine. Allergy. 2013; 68:229–35.
Article
16. Harris A, Twarog FJ, Geha RS. Chronic urticaria in childhood: natural course and etiology. Ann Allergy. 1983; 51(2 Pt 1):161–5.
17. Kang HS, Shin MY. Clinical aspects of chronic urticaria in children. Korean J Pediatr. 2009; 52:205–12.
Article
18. Ye YM, Park JW, Kim SH, Ban GY, Kim JH, Shin YS, et al. Prognostic factors for chronic spontaneous urticaria: a 6-month prospective observational study. Allergy Asthma Immunol Res. 2016; 8:115–23.
Article
19. Confino-Cohen R, Chodick G, Shalev V, Leshno M, Kimhi O, Goldberg A. Chronic urticaria and autoimmunity: associations found in a large population study. J Allergy Clin Immunol. 2012; 129:1307–13.
Article
20. Lee SY, Song WJ, Jung JW, Park HW, Cho SH, Min KU, et al. Thyroid autoantibodies and the prognosis of chronic idiopathic urticaria. Allergy Asthma Respir Dis. 2013; 1:151–6.
Article
21. Kjellman NM, Johansson SG, Roth A. Serum IgE levels in healthy children quantified by a sandwich technique (PRIST). Clin Allergy. 1976; 6:51–9.
Article
22. Chung HL. Clinical significance of serum IgE. Korean J Pediatr. 2007; 50:416–21.
Article
23. Amarasekera M. Immunoglobulin E in health and disease. Asia Pac Allergy. 2011; 1:12–5.
Article
24. Lee JH, Kim JH, Yun SW, Han YS, Ahn K, Chae SA, et al. Differences of the clinical manifestations and laboratory tests between monosensitized and polysensitized children: a single center study. Pediatr Allergy Respir Dis. 2011; 21:277–84.
Article
25. Choi SY, Park HY, Ahn YM. Chronic urticaria in childhood: etiology and outcome. Pediatr Allergy Respir Dis. 2007; 17:38–47.
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