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The natural history of chronic urticaria in childhood: a prospective study
Somboon Chansakulporn1, Sureerat Pongpreuksa2, Preeda Sangacharoenkit2
1Division of Allergy and Immunology, Department of Pediatrics, Srinakarinwirot University, Bangkok, Thailand.
Insights
Children with chronic urticaria (CU) generally experience a favorable outcome, with a significant remission rate over time. Chronic autoimmune urticaria (CAU) in children does not appear to prolong the condition.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Clinical Immunology
Background:
- Prospective studies on the natural history of chronic urticaria (CU) in children are limited.
- Understanding the long-term course of CU in pediatric populations is crucial for effective management.
Purpose of the Study:
- To investigate the natural history of chronic urticaria (CU) in children.
- To identify potential predictors for achieving remission in pediatric CU cases.
Main Methods:
- A cohort of 92 children (aged 4-15) with CU underwent comprehensive investigations, including blood tests, allergy assessments, and parasite screening.
- Remission was defined as a minimum of 12 months symptom-free without medication.
- Follow-up duration was a median of 4.3 years.
Main Results:
- Chronic autoimmune urticaria (CAU) was diagnosed in 40% of patients.
- Remission rates at 1, 3, and 5 years were 18.5%, 54%, and 67.7%, respectively.
- No significant difference in remission rates was observed between CAU and non-CAU groups; no predictors for remission were identified.
Conclusions:
- Children with chronic urticaria exhibit a favorable prognosis.
- Chronic autoimmune urticaria in children does not necessarily lead to a more persistent or intractable disease course.
Background:
There are few prospective studies on the natural course of chronic urticaria (CU) in children.
Objective:
We sought to examine the natural history of CU in children and to identify predictors for remission.
Methods:
Children 4 to 15 years of age with CU were investigated with a complete blood cell count, erythrocyte sedimentation rate, antinuclear antibody titer, complement CH50 level, thyroid studies, autologous serum skin test, skin-prick tests, food challenges, and stool examination for parasites. They were considered to be in remission if symptoms did not recur for at least 12 months without medication.
Results:
In all, 92 children (53.3% female) with CU were recruited and followed up for a median duration of 4.3 years (range 2.5-5.8 years). Chronic autoimmune urticaria (CAU) was identified in 40% of the patients. Food allergy was found in 8.7% and parasitic infestations in 5.4%. Remission rates at 1, 3, and 5 years after the onset of CU symptoms were 18.5%, 54%, and 67.7%, respectively. The remission rate did not differ in CAU compared with non-CAU. No predictor of CU remission was identified.
Limitations:
The basophil histamine release assay was not performed.
Conclusion:
Children with CU have a favorable outcome. CAU did not have an intractable course.
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