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Exposures and outcomes of children with urticaria seen in a pediatric practice-based research network: a case-control
1Department of Pediatrics, University of Indiana School of Medicine, Indianapolis, USA.
Insights
Pediatric urticaria, or hives, often resolves within 9 days. Antibiotic use and gastrointestinal symptoms were linked to childhood hives, with viral illness frequently suspected by pediatricians.
Area of Science:
- Pediatrics
- Allergy and Immunology
- Epidemiology
Background:
- Urticaria is a common pediatric condition.
- Understanding its causes, duration, and management in primary care is essential.
Purpose of the Study:
- To determine the duration, outcomes, and associated findings of urticaria in children managed by general pediatricians.
- To compare exposures (foods, medications, insect stings) and symptoms in children with urticaria versus controls.
- To assess the management strategies employed by general pediatricians for pediatric urticaria.
Main Methods:
- A case-control study design was utilized.
- Fifty-two children with urticaria and 47 matched controls were enrolled from the Utah Pediatric Practice Based Research Network.
- Data collected included urticaria duration, associated symptoms, medical history, exposures, and treatments.
Main Results:
- The mean duration of urticaria was 8.9 days.
- Children with urticaria were significantly more likely to be taking antibiotics (odds ratio [OR] 22.3) and to have gastrointestinal symptoms (OR 3.1) compared to controls.
- No significant differences were found in other symptoms, atopy history, food ingestion, or insect stings between cases and controls.
Conclusions:
- Antibiotic use and gastrointestinal symptoms are associated with pediatric urticaria.
- A viral illness was the most frequently suspected cause by pediatricians.
- Further research may clarify the role of antibiotics and gastrointestinal issues in pediatric urticaria.
Objectives:
(1) To determine the duration, outcome, and associated findings of urticaria in children seen by general pediatricians; (2) to compare the exposure to foods, medications, insect stings or bites, and the presence of other symptoms in children with urticaria with controls; (3) to determine general pediatricians' management of urticaria.
Design:
Case-control.
Participants:
Children with urticaria seen by Utah Pediatric Practice Based Research Network members between August 1, 1999, and August 31, 2000. Control patients were matched for age and sex.
Main Outcome Measures:
Duration of urticaria; associated symptoms; personal and family history of atopy; medications; ingestion of peanuts, nuts, shellfish, tomatoes, strawberries, or eggs; being stung by an insect; suspected cause, diagnostic studies; treatment.
Results:
Fifty-two cases and 47 controls were enrolled. The mean duration of urticaria was 8.9 days (range, 1-50 days). Seventeen patients (33%) and 1 control patient were taking antibiotics (odds ratio [OR], 22.3; 95% confidence interval [CI], 2.8-176; chi(2), P<.001). Fourteen patients and 5 controls had gastrointestinal symptoms (OR, 3.1; 95% CI, 1.02-9.4; chi(2), P =.04). There were no differences between cases and controls for other symptoms, personal or family history of atopy, ingestion of the foods listed, insect sting, or other medications. A cause was suspected in 28 patients (54%): a "viral illness" (19%), antibiotics (15%), or a combination (35%).
Conclusions:
Patients were more likely than controls to be taking an antibiotic and were more likely to have a personal or family history of atopy or to report ingesting foods commonly associated with urticaria. A viral illness was the most common cause suspected by pediatricians.
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