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慢性自发性荨麻疹的诊断方法——需要检测什么及原因。

The Diagnostic Workup in Chronic Spontaneous Urticaria-What to Test and Why.

机构信息

Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Respiratory Medicine, Box Hill Hospital, Melbourne, Vic, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia.

出版信息

J Allergy Clin Immunol Pract. 2021 Jun;9(6):2274-2283. doi: 10.1016/j.jaip.2021.03.049. Epub 2021 Apr 20.

DOI:10.1016/j.jaip.2021.03.049
PMID:33857657
Abstract

BACKGROUND

In chronic spontaneous urticaria (CSU), the guidelines recommend very limited diagnostic procedures during the routine workup, although additional investigations might be indicated in some patients with CSU. For physicians treating patients with CSU, it is often difficult to decide which diagnostic tests are useful.

OBJECTIVE

To provide recommendations on what diagnostic tests should be performed on which patients with CSU.

METHODS

We performed an extensive literature search on the respective topics and identified relevant questions that should prompt diagnostic procedures based on the published evidence and expert consensus among all authors.

RESULTS

We provide questions, diagnostic testing, where appropriate, and recommendation that should be included when assessing the history of a patient with CSU, to explore and rule out differential diagnoses, to assess patients for underlying causes and modifying conditions, to explore patients for comorbid diseases and consequences of having CSU, and to assess patients for CSU components that can help to predict their disease course and response to treatment.

CONCLUSIONS

Here, we provide physicians treating patients with CSU with information about which clues should lead to which tests and why.

摘要

背景

在慢性自发性荨麻疹(CSU)中,指南建议在常规检查期间仅进行非常有限的诊断程序,尽管在一些 CSU 患者中可能需要进行额外的检查。对于治疗 CSU 患者的医生来说,通常很难决定哪些诊断测试是有用的。

目的

提供有关应在哪些 CSU 患者中进行哪些诊断测试的建议。

方法

我们对各个主题进行了广泛的文献检索,并确定了根据已发表的证据和所有作者之间的专家共识应该提示诊断程序的相关问题。

结果

我们提供了在评估 CSU 患者的病史时应包括的问题、诊断测试(如有)和建议,以探索和排除鉴别诊断、评估患者的潜在原因和改变条件、探索患者的合并症和 CSU 的后果,以及评估有助于预测疾病过程和对治疗反应的 CSU 成分的患者。

结论

在这里,我们为治疗 CSU 患者的医生提供了有关哪些线索应该导致哪些测试以及为什么的信息。

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引用本文的文献

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World Allergy Organ J. 2025 Jun 9;18(7):101068. doi: 10.1016/j.waojou.2025.101068. eCollection 2025 Jul.
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Evaluation of Bilastine's Efficacy and Safety in Treating Chronic Idiopathic Urticaria in Iraqi Patients.比拉斯汀治疗伊拉克慢性特发性荨麻疹患者的疗效和安全性评估。
Med J Islam Repub Iran. 2024 Oct 21;38:121. doi: 10.47176/mjiri.38.121. eCollection 2024.
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Omalizumab in Chronic Spontaneous Urticaria: A Real-World Study on Effectiveness, Safety and Predictors of Treatment Outcome.
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Clin Cosmet Investig Dermatol. 2024 Aug 7;17:1799-1808. doi: 10.2147/CCID.S470160. eCollection 2024.
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Disease burden and predictors associated with non-response to antihistamine-based therapy in chronic spontaneous urticaria.慢性自发性荨麻疹中与基于抗组胺药治疗无反应相关的疾病负担及预测因素
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