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[Etiology and clinical course of urticaria in hospitalized children]
Edyta Machura1, Monika Jońska-Golus, Helena Krakowczyk
1Katedra i Klinika Pediatrii, ul. 3 Maja 13/15, 41-800 Zabrze. machurae@poczta.fm
Insights
Acute urticaria is the most common reason for hospitalization in children, often triggered by respiratory infections. IgE-related allergies are rare causes of childhood urticaria, with many chronic cases remaining idiopathic.
Area of Science:
- Pediatric Dermatology
- Allergology and Immunology
- Infectious Diseases
Context:
- Childhood urticaria epidemiology and etiology remain debated.
- Hospitalized children with urticaria present diverse clinical features and underlying causes.
- Understanding the triggers and course of pediatric urticaria is crucial for effective management.
Purpose:
- To investigate the clinical presentation of urticaria in hospitalized children.
- To identify the potential etiologies of childhood urticaria.
- To analyze the relationship between urticaria types, clinical findings, and laboratory results.
Summary:
- A study of 98 hospitalized children revealed acute urticaria as the most frequent diagnosis (70.4%).
- Respiratory tract infections were the primary identified etiology (43 cases), followed by drugs and lambliasis.
- Elevated C-reactive protein and leukocyte levels were noted in acute urticaria, while IgE and eosinophil levels showed no significant differences across urticaria forms.
Impact:
- This study highlights respiratory infections as a key trigger for acute urticaria in children.
- It underscores the low prevalence of IgE-related allergies as a cause for pediatric urticaria.
- The findings suggest a need for further research into the undetermined etiologies of recurrent and chronic urticaria in children.
Introduction:
Data concerning the epidemiology, etiology and clinical course of childhood urticaria are still under discussion.
Aim:
To investigate the clinical presentation of urticaria in hospitalized children and to define its possible etiologies.
Material And Methods:
Ninety eight children (male/female 42/57) aged 0.2-17.6 years, (mean age 8.22±0.55) hospitalized due to urticaria were included in the study. The nature and localization of skin lesions, accompanying diseases and diagnostic test results were analyzed.
Results:
Sixty nine children (70.4%) were diagnosed as having acute, 22 (22.5%) acute recurrent and 7 (7.1%) chronic urticaria. Allergic diseases, family history of atopy and adenoid hypertrophy and/or chronic tonsillitis were present respectively in 10 (10.2%), 28 (28.6%), 21 (21.4%) children. In 32 children (46.3%) with acute urticaria, in 8 (36.3%) with recurrent and in 2 (28.5%) with chronic urticaria skin lesions covered the whole body. Serum C-reactive protein and leukocyte levels in children with acute urticaria were significantly higher compared to children with chronic urticaria (p<0.05). The serum IgE levels, the percentage and absolute count of eosinophils were similar in different forms of urticaria. Probable etiology in 62/69 children with acute urticaria (respiratory tract infections - 43, drugs - 8, lambliosis - 6, food allergy - 2, antiallergy shots - 2, urinary tract infection - 1 child), in 9/22 children with recurrent urticaria (respiratory tract infection - 7, lambliosis - 2 children) and in 3/7 children with chronic urticaria (physical urticaria - 2, urinary tract infection - 1 child) was determined.
Conclusions:
Among children with urticaria, the most frequent cause for hospitalization is acute urticaria. The outbreak of hives wheels is usually triggered by upper respiratory tract infection. IgE-related allergy is a rare reason of childhood urticaria. In more than 50% of cases of recurrent and chronic urticaria the etiology was not determined.
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