Láinez-Nuez Ana, Salas-Parra Gema, Juárez-Guerrero Alba, Picó-Peris Alfonso, Baeza Maria Luisa
Allergy Section, Hospital IMED Valencia, Valencia, Spain.
Allergy Section, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
J Allergy Clin Immunol Glob. 2024 May 9;3(3):100278. doi: 10.1016/j.jacig.2024.100278. eCollection 2024 Aug.
Chronic histaminergic angioedema (CHA) may be classified as a separate acquired angioedema (AE) or as an endotype of chronic spontaneous urticaria (CSU). A recent study suggested them to be independent pathologies.
We carried out an exhaustive analysis between CHA and AE-CSU to explore the possible differentiation between them on the bases of a series of predictors.
An observational, retrospective, cross-sectional, and exploratory study was designed. Fifty-six CHA and 40 AE-CSU patients were included. Data were extracted from the year before and year after time of diagnosis. A predictive model was generated by logistic regression, and its discriminatory power was assessed using the area under the receiver operating characteristic curve.
The average frequency of AE attacks per year turned out to be higher in the AE-CSU group than in the CHA group, both before (median [interquartile range] 12 [43] vs 8 [16]) and after (24.3 [51.2] vs 2 [4.25]) diagnosis, respectively. The uvula was more frequently affected in CHA. No other differences were found. However, using 7 clinical characteristics of the patients, a multiple logistic regression model was able to predict, with a specificity of 86.4%, a sensitivity of 92.3%, and an area under the curve of 95.1% ( = .024), that CHA and AE-CSU behaved differently.
CHA has similar characteristics to AE-CSU, although they slightly differed in the frequency of attacks and their location. Despite its similarities, a multiple logistic regression model that used clinical and evolutionary characteristics allowed the differentiation of both pathologies and supports the idea that these 2 entities are independent.
慢性组胺能性血管性水肿（CHA）可被分类为一种单独的获得性血管性水肿（AE）或慢性自发性荨麻疹（CSU）的一种内型。最近的一项研究表明它们是独立的病理状态。
我们对CHA和AE-CSU进行了详尽分析，以探索基于一系列预测指标二者之间可能存在的差异。
设计了一项观察性、回顾性、横断面探索性研究。纳入了56例CHA患者和40例AE-CSU患者。数据提取自诊断前一年和诊断后一年。通过逻辑回归生成预测模型，并使用受试者工作特征曲线下面积评估其鉴别能力。
AE-CSU组每年AE发作的平均频率在诊断前（中位数[四分位间距]12[43]比8[16]）和诊断后（24.3[51.2]比2[4.25]）均高于CHA组。CHA患者悬雍垂受累更为频繁。未发现其他差异。然而，利用患者的7项临床特征，一个多元逻辑回归模型能够以86.4%的特异性、92.3%的敏感性和95.1%的曲线下面积（P = 0.024）预测CHA和AE-CSU表现不同。
CHA与AE-CSU具有相似特征，尽管它们在发作频率和发作部位略有不同。尽管二者有相似之处，但一个使用临床和病程特征的多元逻辑回归模型能够区分这两种病理状态，并支持这两种实体是独立的观点。
