Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Pediatr Allergy Immunol. 2021 Jan;32(1):146-152. doi: 10.1111/pai.13324. Epub 2020 Aug 24.
Chronic inducible urticaria (CIndU) is a subtype of chronic urticaria induced by a physical stimulus.
To evaluate the clinical features, prognostic factors, and natural course of childhood CIndU subtypes.
Patients (1-18 years old, n = 117) diagnosed with CIndU between March 2011 and March 2019 were analyzed. Patients (n = 101) were re-evaluated for the status of their CIndU at least 6 months after the initial evaluation.
The study population comprised of 117 children with a median (inter-quartile range) age of 10.3 (6-14.8) years at admission and a male predominance (53%). Symptomatic dermographism was the most common type of CIndU, affecting 65% of the group, followed by cold urticaria and cholinergic urticaria, which affected 17% and 15.4%, respectively. Baseline serum tryptase levels in cholinergic urticaria and cold urticaria were higher than those in symptomatic dermographism [7.0 (3.3-10.7) μg/L, 4.2 (2.8-9.3) μg/L, and 2.7 μg/L (1.8-5.9), respectively; P = .020]. Recovery was observed in 9.6%, 25.3%, and 34.7% of the CIndU children after 12, 36, and 60 months, respectively. Of the patients with symptomatic dermographism, 40% had remission in 5 years, whereas this rate was only one-fifth in patients with cold urticaria. The worst prognosis was observed in patients with cholinergic urticaria.
This study concluded that nearly one-third of children with CIndU recovered within 5 years and symptomatic dermographism has the best prognosis. Cholinergic urticaria is the CIndU type with the worst prognosis, male dominance, and highest baseline serum tryptase levels.
慢性诱导性荨麻疹（CIndU）是一种由物理刺激引起的慢性荨麻疹亚型。
评估儿童 CIndU 亚型的临床特征、预后因素和自然病程。
分析 2011 年 3 月至 2019 年 3 月期间诊断为 CIndU 的 117 例患者（1-18 岁，n=117）。对至少在初次评估后 6 个月再次评估的 101 例患者（n=101）进行 CIndU 状态评估。
该研究人群包括 117 名儿童，中位（四分位距）年龄为 10.3（6-14.8）岁，男性居多（53%）。症状性划痕症是最常见的 CIndU 类型，影响了该组的 65%，其次是冷性荨麻疹和胆碱能性荨麻疹，分别影响了 17%和 15.4%。胆碱能性荨麻疹和冷性荨麻疹患者的基线血清类胰蛋白酶水平高于症状性划痕症[7.0（3.3-10.7）μg/L、4.2（2.8-9.3）μg/L 和 2.7μg/L（1.8-5.9）；P=0.020]。12、36 和 60 个月后，CIndU 患儿的恢复率分别为 9.6%、25.3%和 34.7%。在症状性划痕症患者中，40%的患者在 5 年内缓解，而冷性荨麻疹患者的这一比例仅为五分之一。胆碱能性荨麻疹患者的预后最差。
本研究表明，近三分之一的 CIndU 患儿在 5 年内可自行缓解，症状性划痕症的预后最好。胆碱能性荨麻疹是 CIndU 中预后最差的类型，以男性为主，基线血清类胰蛋白酶水平最高。
