慢性荨麻疹治疗实践方面的专家共识
Expert consensus on practical aspects in the treatment of chronic urticaria.
作者信息
Bauer Andrea, Dickel Heinrich, Jakob Thilo, Kleinheinz Andreas, Lippert Undine, Metz Martin, Schliemann Sibylle, Schwichtenberg Uwe, Staubach Petra, Valesky Eva, Wagner Nicola, Wedi Bettina, Maurer Marcus
机构信息
University Hospital Carl Gustav Carus, Department of Dermatology, University Allergy Center, Urticaria Center of Reference and Excellence (UCARE), Technical University, Dresden, Germany.
Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
出版信息
Allergo J Int. 2021;30(2):64-75. doi: 10.1007/s40629-021-00162-w. Epub 2021 Feb 24.
BACKGROUND
Chronic urticaria (CU) is a common disease which represents a considerable burden for many patients. The current urticaria guideline describes the evidence-based diagnosis and treatment of CU. In addition, however, questions often arise in everyday practice that are not addressed by the guideline.
METHODS
In May 2020, a digital meeting with German urticaria experts was held, in which practical aspects of CU treatment were discussed and supporting aids for everyday clinical treatment formulated. The resulting advice in this document focus on practical questions and the available literature and experiences of the participants.
RESULTS
The diagnosis of CU can be made in a short time by means of a thorough anamnesis, a physical examination, and a basic laboratory chemical diagnosis. For this purpose, practical recommendations for everyday practice are given in this paper. An extended diagnosis is only indicated in a few cases and should always be carried out in parallel with an effective therapy. In general, CU should always be treated in the same way, regardless of whether wheals, angioedema or both occur. Symptomatic therapy should be carried out according to the treatment steps recommended by the guidelines. This publication provides practical advice on issues in everyday practice, such as the procedure in the current coronavirus disease 2019 (COVID-19) pandemic, the cardiac risk under higher dosed H1 antihistamines, the self-administration of omalizumab as well as vaccination under omalizumab therapy. In addition to treatment recommendations, topics such as documentation in the practice and family planning with urticaria will be discussed.
DISCUSSION
These supporting treatment recommendations serve as an addendum to the current CU guideline and provide support in dealing with CU patients in everyday practice. The aim is to ensure that patients suffering from CU achieve complete freedom of symptoms with the help of an optimal therapy.
SUPPLEMENTARY INFORMATION
The online version of this article (10.1007/s40629-021-00162-w) contains supplementary material, which is available to authorized users.
背景
慢性荨麻疹（CU）是一种常见疾病，给许多患者带来了相当大的负担。当前的荨麻疹指南描述了基于证据的CU诊断和治疗方法。然而，在日常实践中，经常会出现一些指南未涉及的问题。
方法
2020年5月，与德国荨麻疹专家举行了一次线上会议，讨论了CU治疗的实际问题，并制定了日常临床治疗的辅助工具。本文给出的建议聚焦于实际问题以及参与者的现有文献和经验。
结果
通过全面的病史采集、体格检查和基本的实验室化学诊断，可以在短时间内做出CU的诊断。为此，本文给出了日常实践的实用建议。仅在少数情况下需要进行扩展诊断，并且应始终与有效的治疗同时进行。一般来说，无论出现风团、血管性水肿还是两者都出现，CU都应以相同的方式治疗。对症治疗应按照指南推荐的治疗步骤进行。本出版物提供了日常实践中问题的实用建议，例如当前2019冠状病毒病（COVID-19）大流行中的处理程序[1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,1
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