Çocukluk Çağındaki Kronik Ürtikerli Olguların Etiyolojik Açıdan Değerlendirilmesi

Abstract

Objective: The etiology of chronic urticaria is usually considered idiopathic. There is limited data regarding childhood chronic urticaria in the literature. The aim of the study was to investigate the factors that can play a role in the etiology of chronic urticaria in children and the related clinical and laboratory findings. Material and Methods: We retrospectively evaluated the medical records of 80 children aged under 18 years who attended our clinic and were diagnosed with chronic urticaria. Clinical characteristics, laboratory findings and tests for atopy, infection, autoimmunity and physical urticaria were evaluated. Results: Eighty children with chronic urticaria were enrolled in the study. The mean age of the patients was 10.2±4.1 years. 41 (51.2%) of the patients were female. Of the study population, 46.3% and 53.7% were diagnosed as having chronic spontaneous urticaria and chronic physical urticaria, respectively. The most common comorbid diseases were; autoimmune disease (10%) (5 autoimmune thyroiditis, 1 juvenile rheumatoid arthritis, 1 diabetes, 1 acute rheumatic carditis), chronic gastritis or reflux (8.7%) and nonsteroidal anti-inflammatory drug allergy (5%). Of the patients, 23.7% had atopy, 16.4% had Helicobacter pylori positivity, 20.3% had thyroid autoantibody, 33.3% had antinuclear antibody (ANA) positivity, 25% had food additive related urticaria and 6.7% had positive stool examination for parasites. Autologous serum skin test (ASST) results were positive in 37.8% of the patients. The comparison of patients with positive and negative ASST showed no statistically significant differences in terms of age, gender, presence of atopy, autoimmune disease, ANA positivity, presence of antithyroid antibody and H. pylori positivity. Among the causes of physical urticaria, dermographism, cholinergic urticaria, delayed pressure urticaria, and cold and solar urticaria were found in 45%, 32.4%, 8.7%, 8% and 4.7%, respectively. Conclusion: The etiology of childhood chronic urticaria is mainly related to autoimmunity and physical urticaria. Identification of clinical features and possible causes will contribute to a better management of chronic urticaria in children.