Esteves Caldeira L, Paulino M, Coutinho C, Neto M, Pereira Barbosa M, Costa C
Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal.
University Clinic of Immunoallergology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Eur Ann Allergy Clin Immunol. 2023 Jan;55(1):9-18. doi: 10.23822/EurAnnACI.1764-1489.209. Epub 2021 May 5.
Chronic urticaria (CU) is a frequent disease, with a prevalence of at least 1%. It is characterized by pruritic wheals, angioedema or both for a period longer than 6 weeks. Identify the demographic, clinical, laboratory and therapeutic profile of patients treated in a Portuguese Urticaria Center of Reference and Excellence (UCARE) and compare it with international series. Retrospective analysis of database of patients observed in a specialized urticaria outpatient clinic, from January 2017 through September 2019, of a UCARE center in Portugal. Demographic and clinical features, laboratory findings and pharmacological treatment were obtained from the records. Descriptive analyses were performed for all variables. Chi square and fisher's exact tests were applied to analyze the independence of variables and the fit of distribution. P less than 0.05 was considered significant. During this period, 477 patients were observed, of whom 429 (90%) were diagnosed with chronic urticaria. Mean age (years) at the onset of symptoms was 43.7 (standard deviation (SD) 17.6, range 6-88) and at diagnosis 46.7 (SD 17.8, range 6-88) resulting in an average diagnostic delay of 3 years (range 0-25). Median follow-up period since first attendance in the specialized outpatient clinic was 1.7 years (interquartile range (IQR) 0.79, range 0.1-2.75) . Concerning the whole group of CU patients, 347 (81%) had chronic spontaneous urticaria (CSU) - 79% female, 39 (9%) had isolated chronic inducible urticaria (CIndU) and 43 (10%) had CSU with CIndU. Autologous serum skin test (ASST) was done in 76 patients (positive in 24 (32%)) and basophil activation test (BAT) was done in 38 (positive in 13 (34%)). At the moment of study, 204 (48%) of CU patients were medicated with a second-generation H1-antihistamine (sgAH) daily (first-line therapy), 99 (23%) with sgAH up to four times the standard dose (second-line therapy) and 126 (29%) with omalizumab (third-line therapy). Additionally, 7 (2%) patients were completing a short course of systemic corticosteroids for management of disease exacerbation. Disease control was achieved in 316 of CSU patients (81%). . Referral to a specialized urticaria outpatient clinic is important for a proper assessment of the disease and adequately symptom control.
慢性荨麻疹（CU）是一种常见疾病，患病率至少为1%。其特征为瘙痒性风团、血管性水肿或两者兼具，持续时间超过6周。确定在葡萄牙卓越荨麻疹参考中心（UCARE）接受治疗的患者的人口统计学、临床、实验室和治疗特征，并与国际系列进行比较。对葡萄牙一家UCARE中心2017年1月至2019年9月在专门的荨麻疹门诊观察的患者数据库进行回顾性分析。从记录中获取人口统计学和临床特征、实验室检查结果及药物治疗情况。对所有变量进行描述性分析。应用卡方检验和费舍尔精确检验分析变量的独立性和分布拟合情况。P值小于0.05被认为具有统计学意义。在此期间，共观察了477例患者，其中429例（90%）被诊断为慢性荨麻疹。症状出现时的平均年龄（岁）为43.7（标准差（SD）17.6，范围6 - 88），诊断时为46.7（SD 17.8，范围6 - 88），平均诊断延迟为3年（范围0 - 25）。自首次到专门门诊就诊后的中位随访期为1.7年（四分位间距（IQR）0.79，范围0.1 - 2.75）。在整个慢性荨麻疹患者组中，347例（81%）患有慢性自发性荨麻疹（CSU）——女性占79%，39例（9%）患有孤立性慢性诱导性荨麻疹（CIndU），43例（10%）患有CSU合并CIndU。76例患者进行了自体血清皮肤试验（ASST）（24例（32%）为阳性），38例进行了嗜碱性粒细胞活化试验（BAT）（13例（34%）为阳性）。在研究时，204例（48%）慢性荨麻疹患者每日服用第二代H1抗组胺药（sgAH）（一线治疗），99例（23%）服用sgAH剂量高达标准剂量的四倍（二线治疗），126例（29%）使用奥马珠单抗（三线治疗）。此外，7例（2%）患者正在完成一个短期的系统性糖皮质激素疗程以控制疾病加重。316例CSU患者（81%）实现了疾病控制。转诊至专门的荨麻疹门诊对于正确评估疾病和充分控制症状很重要。
