Yıldırım Güler, Ozceker Deniz, Kaçar Alper, Yücel Esra Özek, Altınel Zeynep Ülker
Department of Pediatric Allergy and Immunology, Cemil Taşçıoğlu City Hospital, Istanbul, Turkey.
Department of Pediatric Emergency, Cemil Taşçıoğlu City Hospital, Istanbul, Turkey.
Pediatr Allergy Immunol. 2025 Mar;36(3):e70053. doi: 10.1111/pai.70053.
Acute urticaria usually resolves spontaneously; however, in some cases, it may progress to CSU. We aimed to investigate the underlying factors of AU in children and the clinical and laboratory factors affecting the progression of AU to CSU.
A prospective analysis was performed in 155 patients under 18 years of age who were diagnosed with AU and treated in our hospital. Factors affecting the transition from acute urticaria to chronic urticaria were analyzed using logistic regression.
Progression of AU to CSU was observed in 9% of patients. The urticaria activity scores of the first week (UAS7) in patients who progressed to CSU were significantly higher than those of patients who did not develop CSU (UAS7: Median 14.5, Min-Max 6-32, p < .001). Additionally, elevated eosinophil levels (Median 3.6%, Min-Max 0-11, p = .006) and the need for more intensive treatments, including parenteral steroids, antihistamines, and additional therapies (42.9% of CU patients, p = .038), were identified as significant risk factors for progression to CSU. In univariate regression analysis, the UAS7 score was found to be statistically significant (OR: 1.131, 95% CI: 1.056-1.212, p < .001). In multivariate analysis, we found that high UAS7 scores (OR: 1.169, 95% CI: 1.072-1.275, p < .001) and the need for combined treatment with additional therapies (OR: 8.240, 95% CI: 1.007-67.441, p = .049) were independent risk factors for progression from AU urticaria to CU.
We found that the severity of urticaria during the first week and the need for additional therapies are important indicators in predicting the risk of chronicity. These findings may help to develop strategies to effectively manage AU in the early stages.
急性荨麻疹通常会自行消退；然而，在某些情况下，它可能会发展为慢性自发性荨麻疹（CSU）。我们旨在研究儿童急性荨麻疹（AU）的潜在因素以及影响AU进展为CSU的临床和实验室因素。
对我院诊断为AU并接受治疗的155名18岁以下患者进行前瞻性分析。使用逻辑回归分析影响急性荨麻疹转变为慢性荨麻疹的因素。
9%的患者出现了AU向CSU的进展。进展为CSU的患者第一周的荨麻疹活动评分（UAS7）显著高于未发展为CSU的患者（UAS7：中位数14.5，最小值 - 最大值6 - 32，p <.001）。此外，嗜酸性粒细胞水平升高（中位数3.6%，最小值 - 最大值0 - 11，p = .006）以及需要更强化的治疗，包括胃肠外类固醇、抗组胺药和其他疗法（42.9%的慢性荨麻疹患者，p = .038），被确定为进展为CSU的显著危险因素。在单因素回归分析中，发现UAS7评分具有统计学意义（OR：1.131，95%CI：1.056 - 1.212，p <.001）。在多因素分析中，我们发现高UAS7评分（OR：1.169，95%CI：1.072 - 1.275，p <.001）和需要联合其他疗法进行治疗（OR：8.240，95%CI：1.007 - 67.441，p = .049）是从急性荨麻疹进展为慢性荨麻疹的独立危险因素。
我们发现第一周荨麻疹的严重程度和额外治疗的需求是预测慢性风险的重要指标。这些发现可能有助于制定在早期有效管理急性荨麻疹的策略。
