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Cold urticaria in Thai children: comparison between cyproheptadine and ketotifen in the treatment
N Visitsunthorn1, M Tuchinda, P Vichyanond
1Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
This study found that ketotifen and cyproheptadine are equally effective in treating cold urticaria in Thai children. Both medications showed good results with mild side effects, and most children recovered fully.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
Background:
- Primary acquired cold urticaria is a condition causing hives upon cold exposure.
- This study focused on Thai children diagnosed with this condition.
Purpose of the Study:
- To compare the effectiveness of two H1 antihistamines, cyproheptadine and ketotifen, in treating cold urticaria in Thai children.
- To evaluate clinical symptoms and response to the ice cube test.
Main Methods:
- A double-blind, cross-over study design was employed.
- Six Thai children with primary acquired cold urticaria participated.
- Effectiveness was assessed through clinical symptom evaluation and the ice cube test.
Main Results:
- No significant difference (p > 0.05) was observed between cyproheptadine and ketotifen in treating cold urticaria symptoms or the ice cube test.
- Both drugs demonstrated good efficacy with mild side effects.
- Five out of six children achieved complete recovery, with one experiencing mild, infrequent exacerbations.
Conclusions:
- Ketotifen is as effective as cyproheptadine for treating cold urticaria in Thai pediatric patients.
- H1 antihistamines provide effective management for cold urticaria, leading to good long-term outcomes.
Abstract:
The study was performed in 6 Thai children with primary acquired cold urticaria. They all suffered from generalized urticaria and two of them also had angioedema. All of them had normal erythrocyte sedimentation rate, complement 3 and negative VDRL, TPHA, hepatitis B screen and cold agglutinin titer. Cryoglobulin was checked in 3 cases and showed negative results A double-blind cross-over study to compare the effectiveness of cyproheptadine and ketotifen demonstrated that the efficacy of cyproheptadine and ketotifen on clinical symptoms and ice cube test was not significantly different (p > 0.05). Both of them showed good results in the treatment of cold urticaria with mild side effects. During the follow up, 5 cases showed complete recovery while the other one developed one or two exacerbations per year upon cold exposure. However, the symptoms were mild and subsided on administration of one or two doses of H1 antihistamine. Our data demonstrated that ketotifen was as effective as cyproheptadine in the treatment of cold urticaria in Thai children.