Pediatric Allergology and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain.
Immunology Department, CDB, Hospital Clínic de Barcelona, Barcelona, Spain.
Pediatr Allergy Immunol. 2023 Mar;34(3):e13929. doi: 10.1111/pai.13929.
Chronic urticaria (CU) is defined as the occurrence of wheals/angioedema for ≥6 consecutive weeks. Until now, guidelines and publications addressing CU have focused mainly on adults. As a result, evidence and guidance in the pediatric population are scarce.
This study aims to describe clinical and laboratory findings in pediatric CU and to determine factors associated with remission.
185 patients, 54% female, median age at onset of 8.8 years. Angioedema was present in almost half. The most common type of CU was chronic spontaneous urticaria (CSU) in 74%. At least one atopic comorbidity was found in almost a third (35%). In addition, 8% had an autoimmune disorder (exclusively in CSU) and 9% had a psychiatric condition. Basopenia was found in 67% and was more frequently associated with CSU. The basophil activation test (BAT) was positive in 40%. With regard to remission, being of male sex, angioedema absence, the absence of physical triggers, and eosinophil counts >0.51 × 10 /L were associated with shorter CU duration.
Atopy is a common condition in pediatric CU. CSU is the most common type. Autoimmune comorbidities and basopenia were significantly more common in CSU. In addition, ours is one of the few studies, assessing BAT utility in the pediatric population, being positive in a relevant percentage (40%). BAT positivity was more frequent in CSU. Our results suggest that the absence of angioedema and physical triggers, male sex, and eosinophil counts >0.51 × 10 /L appear to be associated with a better prognosis in terms of remission.
慢性荨麻疹（CU）定义为风团/血管性水肿持续≥6 周。到目前为止，针对 CU 的指南和出版物主要集中在成年人。因此，儿科人群的证据和指导非常有限。
本研究旨在描述儿科 CU 的临床和实验室发现，并确定与缓解相关的因素。
共纳入 185 例患者，女性占 54%，发病中位年龄为 8.8 岁。近一半患者有血管性水肿。最常见的 CU 类型为慢性自发性荨麻疹（CSU）占 74%。近三分之一（35%）患者存在至少一种特应性合并症。此外，8%患者存在自身免疫性疾病（仅见于 CSU），9%患者存在精神疾病。87%患者存在嗜碱性粒细胞减少，且与 CSU 更相关。嗜碱性粒细胞活化试验（BAT）阳性率为 40%。在缓解方面，男性、无血管性水肿、无物理性诱因、嗜酸性粒细胞计数＞0.51×10/L 与 CU 持续时间更短相关。
特应症是儿科 CU 的常见合并症。CSU 是最常见的类型。自身免疫性合并症和嗜碱性粒细胞减少在 CSU 中更为常见。此外，我们的研究是为数不多的评估 BAT 在儿科人群中应用的研究之一，阳性率为 40%。CSU 中 BAT 阳性率更高。我们的结果表明，无血管性水肿和物理性诱因、男性、嗜酸性粒细胞计数＞0.51×10/L 似乎与缓解预后更好相关。
