Çocuklarda kronik ürtiker tanısında İskemik Modifiye Albüminin yeri ve hastalık şiddetiyle ilişkisi

Abstract

Giriş: Çocukluk çağında ürtiker, klinik şiddeti değişken olan heterojen bir tablodur. Tanıya katkı sağlayacak ve hastalık aktivitesini yansıtabilecek güvenilir biyobelirteçler henüz yeterince tanımlanmamıştır. İskemik Modifiye Albümin (İMA), oksidatif stres ve doku iskemisinin göstergesi olarak önerilmiş olmakla birlikte pediatrik kronik ürtikerdeki yeri net değildir. Çocukluk çağı kronik ürtikerinde serum İMA düzeylerini değerlendirmek ve hastalık aktivitesi ile ilişkisini incelemek. Yöntemler: Kronik ürtiker tanılı 44 çocuk hasta ve yaş ile cinsiyet açısından benzer 43 sağlıklı kontrol çalışmaya dahil edildi. Demografik ve klinik veriler kaydedildi. Serum immunoglobin E (IgE), eozinofil ve İMA düzeyleri ölçüldü. Ürtiker aktivite skoru (ÜAS) hesaplandı. İMA ile klinik/laboratuvar parametreler arasındaki ilişkiler korelasyon analizi ile değerlendirildi. Tanısal doğruluk ROC analizi ile incelendi. Bulgular: Hasta grubunda IgE ve eozinofil düzeyleri kontrol grubuna kıyasla anlamlı derecede yüksekti (p<0,001). İMA düzeyleri hastalarda belirgin olarak artmıştı (22,5±7,28 vs. 15,2±5,02; p<0,001). İMA, ÜAS ile güçlü pozitif korelasyon gösterdi (ρ=0,913; p<0,001), ancak IgE ve eozinofillerle anlamlı ilişki bulunmadı. ROC analizinde İMA’nın ayırt edici gücü mükemmele yakın düzeydeydi (AUC=0,921; %95 GA: 0,863–0,979; p<0,001), optimal eşik değer 18,82 olarak belirlendi. Sonuç: Kronik ürtikerli çocuklarda serum İMA düzeyleri anlamlı şekilde yükselmiştir ve hastalık aktivitesiyle güçlü ilişki göstermektedir. İMA, çocukluk çağı kronik ürtikerinde tanısal sürece katkı sağlayabilecek ve klinik aktiviteyi izlemeye yönelik umut verici bir biyobelirteçtir.

Keywords

• İskemik modifiye albümin
• ürtiker
• çocuk
• biyobelirteç
• hastalık aktivitesi

The Role of Ischemia-Modified Albumin in the Diagnosis of Chronic Urticaria in Children and Its Association with Disease Severity

Abstract

Introduction: Urticaria in childhood is a heterogeneous condition with variable clinical severity. Reliable biomarkers that may aid diagnosis and reflect disease activity have not yet been sufficiently defined. Ischemia-Modified Albumin (IMA) has been proposed as an indicator of oxidative stress and tissue ischemia; however, its role in pediatric chronic urticaria remains unclear. To assess serum IMA levels in children with chronic urticaria and to investigate their relationship with disease activity. Methods: The study included 44 pediatric patients diagnosed with chronic urticaria and 43 age- and sex-matched healthy controls. Demographic and clinical data were recorded. Serum immunoglobulin E (IgE), eosinophil counts, and IMA levels were measured. The urticaria activity score (UAS) was calculated. Correlations between IMA and clinical/laboratory parameters were analyzed, and diagnostic accuracy was evaluated using ROC analysis. Results: IgE levels and eosinophil counts were significantly higher in the patient group compared to controls (p<0.001). Serum IMA levels were markedly elevated in patients (22.5 ± 7.28 vs. 15.2 ± 5.02; p<0.001). IMA showed a strong positive correlation with UAS (ρ=0.913; p<0.001), while no significant associations were observed with IgE or eosinophils. ROC analysis demonstrated an excellent discriminative ability of IMA (AUC=0.921; 95% CI: 0.863–0.979; p<0.001), with an optimal cutoff value of 18.82. Conclusion: Serum IMA levels are significantly increased in children with chronic urticaria and strongly correlate with disease activity. IMA may represent a promising biomarker for supporting the diagnostic process and monitoring clinical activity in pediatric chronic urticaria.

Keywords

• İschemia-modified albumin
• urticaria
• child
• biomarker
• disease activity.

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