Etiological Evaluation of Acute Urticaria in Children

Abstract

Objective: Acute urticaria is one of the most common causes of admission to hospitals in children. The aim of the study is to evaluate the etiology of acute urticaria in patients who admitted to pediatric allergy outpatient clinics. Material and Methods: The patients who were diagnosed as acute urticaria in pediatric allergy outpatient clinics between January 1, 2016 and December 31, 2016 were included in the study. Patient information was recorded retrospectively from medical files. Results: In this study, 469 patients with acute urticaria were evaluated. The median (min-max) age of the patients was 7 years (2 months-18 years), and 48.8 % of them were male. Angioedema was accompanying in 20 % of the patients. Recurrent acute urticaria was seen in 33.5 % (n = 157) of the patients. In the history, infections were the triggers in 37.5 % (n=176) of the patients, drugs in 17.9 % (n=84), food in 10.9 % (n=51), insect bites in 3.2 % (n=15), and 0.2 % (n=1) of them had the vaccine. When the patients were evaluated with the medical histories, physical examination and laboratory findings; triggers could not be detected in 59 % (n=276) and these patients were diagnosed as idiopathic acute urticaria. Infections (37.5 %; n=176) were in the first place in patients with triggers. Food and drug allergies were confirmed in only one patient each. Considering the etiological distribution according to age groups, it was seen that idiopathic acute urticaria was more common in the 12-18 age group and infection-associated acute urticaria in the group under 2 years old (p=0.009). Conclusion: Mostly, triggers cannot be found in children who apply to the allergy clinic due to acute urticaria. In patients who can be identified triggers, infections are in the first place. However, patients’ clinical histories may also include food or drug(s) as a suspected trigger, and it is important to evaluate these patients with diagnostic allergy tests. Thus, misdiagnosis of patients and unnecessary food or drug restrictions would be prevented.