Debbaut A, Gilliaux O
Department of Pediatrics, Hôpital Civil Marie Curie, CHU of Charleroi, 140 Chaussée de Bruxelles, 6042 Charleroi, Lodelinsart, Belgium.
Department of Pediatrics, Hôpital Civil Marie Curie, CHU of Charleroi, 140 Chaussée de Bruxelles, 6042 Charleroi, Lodelinsart, Belgium; Laboratory of Experimental Medicine (ULB222), Faculty of Medicine, Université libre de Bruxelles, Belgium.
Arch Pediatr. 2023 Apr;30(3):131-135. doi: 10.1016/j.arcped.2023.01.010. Epub 2023 Feb 17.
The aim of the study was to focus on children with both chronic spontaneous urticaria (CSU) and autoimmune thyroiditis (AT) as this topic is rarely studied in children although some publications show a higher proportion of antithyroid antibodies in children with CSU. We highlight two cases of children with both CSU and AT and compare their data with reports from the literature. Since only case reports or case series were available, we performed a descriptive analysis of 15 patients. There were 7 (46.7%) cases of hypothyroidism and the rest were euthyroid. Hypothyroidism appears before, during, and after the diagnostic of CSU. One patient with hypothyroidism and one with euthyroidism receiving l-thyroxine experienced remission of urticaria. Three patients over 12 years of age (20%) received omalizumab. Three patients (20%) had another autoimmune disease and seven (58.3%) had a family history of thyroid disease or autoimmune disease. CONCLUSION: Children with CSU need repeated testing for antithyroid antibodies. Children with both CSU and AT require close medical supervision focused on the development of other autoimmune diseases. l-thyroxine may improve urticaria in patients with hypothyroidism, but there is not enough evidence for patients with euthyroidism. Omalizumab may be of benefit in this population but well-controlled studies in children with AT and CSU are needed.
本研究的目的是聚焦于患有慢性自发性荨麻疹（CSU）和自身免疫性甲状腺炎（AT）的儿童，因为尽管一些出版物显示CSU患儿中抗甲状腺抗体的比例较高，但该主题在儿童中很少被研究。我们重点介绍了两例同时患有CSU和AT的儿童病例，并将他们的数据与文献报道进行比较。由于仅有病例报告或病例系列可用，我们对15例患者进行了描述性分析。有7例（46.7%）甲状腺功能减退，其余甲状腺功能正常。甲状腺功能减退在CSU诊断之前、期间和之后出现。一名甲状腺功能减退患者和一名甲状腺功能正常且接受左甲状腺素治疗的患者荨麻疹得到缓解。3名12岁以上的患者（20%）接受了奥马珠单抗治疗。3名患者（20%）患有另一种自身免疫性疾病，7名患者（58.3%）有甲状腺疾病或自身免疫性疾病家族史。结论：CSU患儿需要反复检测抗甲状腺抗体。同时患有CSU和AT的儿童需要密切的医学监测，重点关注其他自身免疫性疾病的发展。左甲状腺素可能改善甲状腺功能减退患者的荨麻疹，但对于甲状腺功能正常的患者没有足够的证据。奥马珠单抗可能对该人群有益，但需要对患有AT和CSU的儿童进行严格对照研究。
