Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, Québec, Canada.
Division of Dermatology, McGill University, Montreal, Québec, Canada.
Int Arch Allergy Immunol. 2021;182(8):757-764. doi: 10.1159/000514757. Epub 2021 Apr 1.
Some forms of chronic urticaria (CU) can be specifically attributed to a response to a definite trigger, referred to as chronic inducible urticaria (CIndU). We aimed to assess the demographics, clinical characteristics, comorbidities, natural history, and management of pediatric patients with CIndU.
Over a 6-year period, children presenting to the allergy clinic at the Montreal Children's Hospital (MCH) with CIndU were prospectively recruited. CU was defined as the presence of wheals and/or angioedema, occurring for at least 6 weeks. A standardized diagnostic test was used to establish the presence of a specific form of urticaria. Resolution was defined as the absence of hives for 1 year without treatment.
Sixty-four patients presented with CIndU, of which 51.6% were male, with a median age of 12.5 (interquartile range 7.3, 15.9) years. Cold CU and cholinergic CU were the most common subtypes (60.3 and 41.3%, respectively). Basophil counts were undetectable in 48.4% of the cases, and C-reactive protein levels were elevated in 7.8% of patients. Of all cases, 71.4% were controlled with second-generation antihistamines. The resolution rate was of 45.3% (95% confidence interval 33.1-57.5%), based on per-protocol population within the 6-year course of the study. Resolution was more likely in patients who presented with well-controlled urticaria control test scores and elevated CD63 counts and in those suffering from thyroid comorbidity.
The natural history of CIndU resolution in pediatric patients was relatively low and was associated with elevated CD63 levels, as well as thyroid comorbidity.
某些形式的慢性荨麻疹（CU）可以归因于对特定触发因素的反应，称为慢性诱导性荨麻疹（CIndU）。我们旨在评估患有 CIndU 的儿科患者的人口统计学、临床特征、合并症、自然病史和治疗方法。
在 6 年期间，前瞻性招募了因 CIndU 到蒙特利尔儿童医院（MCH）过敏诊所就诊的儿童患者。CU 的定义为存在风团和/或血管性水肿，持续至少 6 周。使用标准化诊断测试来确定特定形式的荨麻疹的存在。缓解定义为无荨麻疹 1 年且无需治疗。
64 例患者出现 CIndU，其中 51.6%为男性，中位年龄为 12.5（四分位距 7.3，15.9）岁。冷 CU 和胆碱能 CU 是最常见的亚型（分别为 60.3%和 41.3%）。48.4%的病例嗜碱性粒细胞计数不可检测，7.8%的患者 C 反应蛋白水平升高。在所有病例中，71.4%的患者用第二代抗组胺药控制。根据研究期间 6 年的方案人群，缓解率为 45.3%（95%置信区间 33.1-57.5%）。在具有良好控制的荨麻疹控制测试评分和升高的 CD63 计数的患者以及患有甲状腺合并症的患者中，缓解的可能性更大。
儿科患者 CIndU 缓解的自然病史相对较低，与升高的 CD63 水平以及甲状腺合并症相关。
