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Chronic urticaria: etiology and natural course in children

Umit M Sahiner1, Ersoy Civelek, Ayfer Tuncer

  • 1Department of Pediatric Allergy and Asthma, Hacettepe University Faculty of Medicine, Ankara, Turkey.

International Archives of Allergy and Immunology
|May 21, 2011
PubMed

Insights

Chronic spontaneous urticaria (CSU) in children is often linked to an autoreactive background. While CSU generally has a good prognosis, with half of children recovering within five years, older girls may face a less favorable outcome.

Area of Science:

  • Pediatric Dermatology
  • Allergology
  • Immunology

Background:

  • Chronic spontaneous urticaria (CSU) is uncommon in children, with limited data on its pediatric presentation.
  • Understanding the causes, progression, and prognostic indicators of childhood CSU is crucial.

Purpose of the Study:

  • To investigate the etiologic factors, natural course, and prognostic predictors of chronic spontaneous urticaria in pediatric patients.
  • To compare the characteristics and outcomes of childhood CSU with adult cases.

Main Methods:

  • Retrospective analysis of 100 children (≤18 years) diagnosed with CSU over an 8-year period.
  • Data collection included patient demographics, clinical features, and diagnostic tests (autologous serum skin test, ANA).
  • Outcomes were assessed via telephone interviews to determine disease resolution and identify prognostic factors.

Main Results:

  • A positive autologous serum skin test was observed in 46.7% of patients, with a female predominance.
  • Associated factors included food allergy, thyroid autoantibodies, and possible collagen disease; infections were not confirmed as a cause.
  • Recovery rates were 16.5% at 1 year, 38.8% at 3 years, and 50% at 5 years. Female gender and age over 10 years were associated with an unfavorable prognosis in univariate analysis.

Conclusions:

  • The etiology of pediatric CSU is similar to adults, often involving an autoreactive background.
  • CSU in children typically follows a favorable course, with approximately 50% achieving resolution within 5 years.
  • Adolescent girls (older than 10 years) may represent a subgroup with a less favorable prognosis.
Abstract

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