Chronic autoimmune urticaria in children.

Area of Science:

• Immunology
• Dermatology
• Pediatrics

Background:

• Chronic urticaria in children often lacks a clear cause despite standard investigations.
• Autoimmune mechanisms are increasingly suspected in chronic urticarial conditions.

Purpose of the Study:

• To determine the presence of circulating histamine-releasing autoantibodies in children with chronic urticaria.
• To establish the autoimmune basis of chronic urticaria in pediatric patients using the histamine release urticaria test.

Main Methods:

• The study involved 12 children diagnosed with chronic urticaria.
• A serum-induced basophil histamine release urticaria test was performed at a 12.5% serum dilution.
• Standard allergy testing and laboratory findings were also reviewed.

Main Results:

• The histamine release urticaria test showed a mean histamine liberation of 40.8% (normal <16.5%), indicating autoantibodies against Fc epsilon RI and/or the IgE-Fc epsilon RI complex.
• No correlation was found between histamine release and patient age, symptom duration, or severity.
• Two patients had associated antithyroid autoantibodies.

Conclusions:

• The findings establish an autoimmune etiology for chronic urticaria in these pediatric cases.
• Treatment including antihistamines, dietary modifications, and intravenous immunoglobulin achieved remission in all patients.
• The histamine release urticaria test is a valuable tool for diagnosing autoimmune chronic urticaria in children.