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Urticaria, Angioedema, and Anaphylaxis.

Jennifer Pier1, Theresa A Bingemann1,2

  • 1University of Rochester, Rochester, NY.

Pediatrics in Review
|June 3, 2020
PubMed
Summary

Pediatric urticaria and angioedema are common but usually benign. Early introduction of allergenic foods may prevent food allergies and anaphylaxis, a severe allergic reaction requiring immediate epinephrine treatment.

Area of Science:

  • Pediatric Allergy and Immunology
  • Dermatology
  • Clinical Immunology

Background:

  • Urticaria and angioedema are frequent in children, with diverse causes, often benign but concerning.
  • Chronic urticaria significantly impacts quality of life and requires aggressive management.
  • Anaphylaxis is a severe, systemic allergic reaction necessitating prompt epinephrine administration.

Purpose of the Study:

  • To review the causes, evaluation, and management of urticaria, angioedema, and anaphylaxis in pediatric patients.
  • To highlight the role of allergist evaluation for acute and chronic conditions.
  • To discuss current evidence regarding early food introduction for allergy prevention.

Main Methods:

  • Review of current literature and clinical guidelines on pediatric urticaria, angioedema, and anaphylaxis.

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  • Discussion of diagnostic approaches based on symptom presentation (acute vs. chronic).
  • Analysis of therapeutic strategies, including antihistamines, immunomodulators, and epinephrine.

    • Main Results:

    • Most pediatric urticaria and angioedema cases are benign; allergist evaluation is recommended for suspected external triggers.
    • Chronic symptoms often require aggressive treatment and are less likely linked to external causes.
    • Foods are a common anaphylaxis trigger in children, but early introduction may prevent allergies.

    Conclusions:

    • Prompt evaluation and management by an allergist are crucial for pediatric allergic conditions.
    • Aggressive treatment is necessary for chronic urticaria impacting quality of life.
    • Early introduction of allergenic foods in infancy is safe and may prevent food allergies and anaphylaxis.