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Epidemiological and Clinical Characteristics of Adult and Pediatric Patients with Chronic Spontaneous Urticaria

Aviv Barzilai1,2,3, Alona Baum3, Moshe Ben-Shoshan4

  • 1Department of Dermatology, Sheba Medical Center, Ramat-Gan 52621, Israel.

Journal of Clinical Medicine
|December 9, 2023
PubMed

Insights

Chronic spontaneous urticaria (CSU) affects adults and children similarly, but co-morbidities differ. Autoimmune conditions are common in both groups, impacting treatment strategies for CSU patients.

Area of Science:

  • Dermatology
  • Immunology
  • Pediatrics

Background:

  • Chronic spontaneous urticaria (CSU) is a skin condition characterized by hives lasting over six weeks.
  • The underlying mechanisms of CSU are not fully understood.
  • Limited data exist on pediatric CSU characteristics despite similar prevalence to adults.

Purpose of the Study:

  • To investigate and compare the epidemiology, clinical features, and treatment of CSU in pediatric and adult populations.
  • To identify differences in co-morbidities and treatment responses between age groups.

Main Methods:

  • A cross-sectional study involving 193 CSU patients treated between 2009-2022.
  • Data collected included demographics, triggers, co-morbidities (atopic, autoimmune), treatments, and outcomes.
  • Patients were categorized into pediatric (≤18 years) and adult groups.

Main Results:

  • Metabolic syndrome was more common in adults, while atopy was more prevalent in pediatrics.
  • Autoimmune co-morbidities were observed in approximately 34.7% of adults and 34.8% of pediatrics.
  • Inflammatory bowel disease and thyroid disease were the most frequent autoimmune co-morbidities in pediatrics and adults, respectively. Systemic treatments beyond antihistamines were more common in adults, especially those with autoimmune conditions.

Conclusions:

  • CSU management may differ between pediatric and adult patients due to varying co-morbidity profiles.
  • Adults with autoimmune CSU often require second-line immunomodulatory treatments.
  • Autoimmune co-morbidities in CSU patients can complicate management, suggesting early consideration of biologics.

Keywords:
Omalizumabatopic diseasesautoimmune co-morbiditieschronic spontaneous urticariasecond-generation antihistamine

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