Corral-Magaña Oriol, Gil-Sánchez José Antonio, Bover-Bauzá Catalina, Martinez-Cepas Patricia, Montis-Palos María Concepción, Martín-Santiago Ana
Department of Dermatology, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
Department of Pediatric Allergology, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
Pediatr Dermatol. 2021 Mar;38(2):385-389. doi: 10.1111/pde.14455. Epub 2021 Jan 7.
BACKGROUND/OBJECTIVES: The aim of the study was to describe the clinical characteristics, management, and outcome of a series of children with chronic urticaria (CU).
We retrospectively studied children aged <15 years diagnosed with CU in a tertiary teaching hospital in Palma de Mallorca, Spain, between January 2014 and March 2019. CU was defined as persistence of symptoms of wheals, with or without angioedema, for >6 weeks.
Twenty-nine patients (17 girls, mean age 8 years) were included. Family history of atopy was found in 31% of the cases. In 41.3% of patients, episodes of CU were associated with angioedema. Physical triggers were found in 34.5% of the cases. Most episodes of CU were successfully managed with the recommended (60.7%) or double the recommended dose (17.2%) of H1-antihistamines. Quadruple the recommended dose of H1 antihistamines was used in six patients, five of whom were finally treated with off-label omalizumab. Treatment with anti-leukotrienes was needed in one patient. Associated thyroiditis was diagnosed in one patient, which was controlled with levothyroxine.
Pediatric CU showed features similar to CU in adulthood, including a greater predominance in females and frequent association with personal or family history of atopy. Adult guidelines for the treatment of CU are currently extrapolated to the pediatric population. Specific tools for the assessment of disease activity and impairment of quality of life in pediatric CU are needed for use in prospective studies aimed to define treatment strategies for children with CU.
背景/目的：本研究旨在描述一系列慢性荨麻疹（CU）患儿的临床特征、治疗及预后情况。
我们回顾性研究了2014年1月至2019年3月在西班牙马略卡岛帕尔马的一家三级教学医院确诊为CU的15岁以下儿童。CU定义为风团症状持续存在，伴或不伴有血管性水肿，持续时间超过6周。
共纳入29例患者（17名女孩，平均年龄8岁）。31%的病例有特应性家族史。41.3%的患者CU发作与血管性水肿有关。34.5%的病例发现有物理诱因。大多数CU发作通过推荐剂量（60.7%）或双倍推荐剂量（17.2%）的H1抗组胺药成功控制。6例患者使用了四倍推荐剂量的H1抗组胺药，其中5例最终接受了超说明书使用的奥马珠单抗治疗。1例患者需要使用抗白三烯药物治疗。1例患者被诊断为伴有甲状腺炎，通过左甲状腺素控制。
儿童CU表现出与成人CU相似的特征，包括女性占比更高以及常与个人或家族特应性病史相关。目前成人CU的治疗指南外推至儿童人群。需要用于评估儿童CU疾病活动度和生活质量受损情况的特定工具，以用于旨在确定儿童CU治疗策略的前瞻性研究。
