Çocukluk Çağındaki Kronik Ürtikerli Olguların Etiyolojik Açıdan Değerlendirilmesi

Tuğba Arıkoğlu

doi:10.12956/tjpd.2017.324

Research Article

Çocukluk Çağındaki Kronik Ürtikerli Olguların Etiyolojik Açıdan Değerlendirilmesi

Year 2018, Volume: 12 Issue: 4, 251 - 257, 30.12.2018

Tuğba Arıkoğlu

https://doi.org/10.12956/tjpd.2017.324

Abstract

Amaç: Kronik ürtikerin etiyolojisi çoğunlukla idiyopatiktir. Çocukluk çağı kronik ürtikeri ile ilgili literatürde sınırlı veri mevcuttur.

Çalışmada, çocuklarda kronik ürtikerin etiyolojisinde rol oynayabilecek faktörler ve ilişkili klinik ve laboratuvar

bulguların araştırılması amaçlandı.

Gereç ve Yöntemler: Kliniğimizde kronik ürtiker tanısı alan 18 yaş altı 80 hasta retrospektif olarak incelendi. Kronik ürtikerli

hastaların klinik özellikleri, laboratuvar bulguları, atopi, enfeksiyon, otoimmünite ve fiziksel ürtikere yönelik tetkikleri

değerlendirildi.

Bulgular: Kronik ürtiker tanısı ile izlenen 80 hasta çalışmaya dahil edildi. Hastaların ortalama yaşı 10.2±4.1 yıldı. 41’i

(%51.2) kızdı. Hastaların %53.7’sinde fiziksel ürtiker, %46.3’ünde kronik spontan ürtiker tesbit edildi. En sık saptanan

komorbid hastalıklar sırasıyla; otoimmün hastalık (%10) (5 otoimmün tiroidit, 1 juvenil romatoid artrit, 1 diyabet, 1 akut

romatizmal kardit), kronik gastrit veya reflü (%8.7) ve nonsteroidal anti-inflamatuvar ilaç (NSAİ) allerjisi (%5) idi. Kronik

ürtikerli hastaların %23.7’sinde atopi, %16.4’ünde helikobakter pylori pozitifliği, %20.3’ünde tiroid otoantikor varlığı,

%33.3’ünde antinükleer antikor (ANA) pozitifliği, %25’inde gıda katkı maddesi ile ilişkili ürtiker, %6.7’sinde dışkıda parazit

saptandı. Otolog serum deri testi pozitifliği (OSDT) %37.8 olarak bulundu. OSDT pozitif (n=14) ve negatif (n=23) hastalar

karşılaştırıldığında; yaş, cinsiyet, atopi, otoimmün hastalık varlığı, ANA pozitifliği, tiroid otoantikor varlığı ve Helikobakter

pylori pozitifliği açısından gruplar arasında anlamlı bir fark saptanmadı. Fiziksel ürtiker nedenleri arasında en sık dermografizm

(%45) görülürken, %32.4’ünde kolinerjik ürtiker, %8.7’sinde gecikmiş basınç ürtikeri, %8’inde soğuk ürtiker ve

%4.7’sinde solar ürtiker tesbit edildi.

Sonuç: Çocuklarda kronik ürtiker etiyolojisinde otoimmünite ve fiziksel ürtiker önemli bir yer tutmaktadır. Şüpheli olgularda

fiziksel ürtiker testlerinin ve ayrıntılı incelemelerin yapılması kronik ürtikerli olguların daha iyi bir şekilde yönetimine

katkı sağlayacaktır.

Keywords

Antinükleer antikor, Çocuklar, Helikobakter pylori, Kronik ürtiker, Otoimmün tiroidit

References

1. Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: The 2013 revision and update. Allergy 2014;69:868-87.
2. Bernstein JA, Lang DM, Khan DA, Craig T, Dreyfus D, Hsieh F, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol 2014;133:1270-7.
3. Khakoo G, Sofianou-Katsoulis A, Perkin MR, Lack G. Clinical features and natural history of physical urticaria in children. Pediatr Allergy Immunol 2008;19:363-6.
4. Church MK, Weller K, Stock P, Maurer M. Chronic spontaneous urticaria in children: Itching for insight. Pediatr Allergy Immunol 2011;22:1-8.
5. Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid- Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: The autologous serum skin test in urticaria. Allergy 2009;64:1256-68.
6. Azkur D, Civelek E, Toyran M, Mısrlıoglu ED, Erkocoglu M, Kaya A, et al. Clinical and etiologic evaluation of the children with chronic urticaria. Allergy Asthma Proc 2016;37:450-57.
7. Sahiner UM,Civelek E, Tuncer A, Yavuz ST, Karabulut E, Sackesen C, et al. Chronic urticaria: Etiology and natural course in children. Int Arch Allergy Immunol 2011;156:224-30.
8. Choi SH, Baek HS. Approaches to the diagnosis and management of chronic urticaria in children. Korean J Pediatr 2015;58:159-64.
9. Wedi B, Raap U, Kapp A. Chronic urticaria and infections. Curr Opin Allergy Clin Immunol 2004;4:387-96.
10. Campanati A, Gesuita R, Giannoni M, Piraccini F, Sandroni L, Martina E, et al. Role of small intestinal bacterial overgrowth and Helicobacter pylori infection in chronic spontaneous urticaria: A prospective analysis. Acta Derm Venereol 2013;93:161-4.
11. Hellmig S, Troch K, Ott SJ, Schwarz T, Fölsch UR. Role of Helicobacter pylori infection in the treatment and outcome of chronic urticaria. Helicobacter 2008;13:341-5.
12. Akelma AZ, Cizmeci MN, Mete E, Tufan N, Bozkurt B. A neglected cause for chronic spontaneous urticaria in children: Helicobacter pylori. Allergol Immunopathol (Madr) 2015;43:259-63.
13. Harris A, Twarog FJ, Geha RS. Chronic urticaria in childhood: Natural course and etiology. Ann Allergy 1983;51:161-5.
14. Weiland SK, Björkstén B, Brunekreef B, Cookson WO, von Mutius E, Strachan DP, et al. Phase II of the International Study of Asthma and Allergies in Childhood (ISAAC II): Rationale and methods. Eur Respir J 2004;24:406-12.
15. Komarow HD, Arceo S, Young M, Nelson C, Metcalfe DD. Dissociation between history and challenge in patients with physical urticaria. J Allergy Clin Immunol Pract 2014;2:786-90.
16. Sánchez-Borges M, González-Aveledo L, Caballero-Fonseca F, Capriles-Hulett A. Review of physical urticarias and testing methods. Curr Allergy Asthma Rep 2017;17:51.
17. Magerl M, Borzova E, Giménez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, et al. The definition and diagnostic testing of physical and cholinergic urticarias-EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy 2009;64:1715-21.

Year 2018, Volume: 12 Issue: 4, 251 - 257, 30.12.2018

Tuğba Arıkoğlu

https://doi.org/10.12956/tjpd.2017.324

Abstract

References

1. Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: The 2013 revision and update. Allergy 2014;69:868-87.
2. Bernstein JA, Lang DM, Khan DA, Craig T, Dreyfus D, Hsieh F, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol 2014;133:1270-7.
3. Khakoo G, Sofianou-Katsoulis A, Perkin MR, Lack G. Clinical features and natural history of physical urticaria in children. Pediatr Allergy Immunol 2008;19:363-6.
4. Church MK, Weller K, Stock P, Maurer M. Chronic spontaneous urticaria in children: Itching for insight. Pediatr Allergy Immunol 2011;22:1-8.
5. Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid- Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: The autologous serum skin test in urticaria. Allergy 2009;64:1256-68.
6. Azkur D, Civelek E, Toyran M, Mısrlıoglu ED, Erkocoglu M, Kaya A, et al. Clinical and etiologic evaluation of the children with chronic urticaria. Allergy Asthma Proc 2016;37:450-57.
7. Sahiner UM,Civelek E, Tuncer A, Yavuz ST, Karabulut E, Sackesen C, et al. Chronic urticaria: Etiology and natural course in children. Int Arch Allergy Immunol 2011;156:224-30.
8. Choi SH, Baek HS. Approaches to the diagnosis and management of chronic urticaria in children. Korean J Pediatr 2015;58:159-64.
9. Wedi B, Raap U, Kapp A. Chronic urticaria and infections. Curr Opin Allergy Clin Immunol 2004;4:387-96.
10. Campanati A, Gesuita R, Giannoni M, Piraccini F, Sandroni L, Martina E, et al. Role of small intestinal bacterial overgrowth and Helicobacter pylori infection in chronic spontaneous urticaria: A prospective analysis. Acta Derm Venereol 2013;93:161-4.
11. Hellmig S, Troch K, Ott SJ, Schwarz T, Fölsch UR. Role of Helicobacter pylori infection in the treatment and outcome of chronic urticaria. Helicobacter 2008;13:341-5.
12. Akelma AZ, Cizmeci MN, Mete E, Tufan N, Bozkurt B. A neglected cause for chronic spontaneous urticaria in children: Helicobacter pylori. Allergol Immunopathol (Madr) 2015;43:259-63.
13. Harris A, Twarog FJ, Geha RS. Chronic urticaria in childhood: Natural course and etiology. Ann Allergy 1983;51:161-5.
14. Weiland SK, Björkstén B, Brunekreef B, Cookson WO, von Mutius E, Strachan DP, et al. Phase II of the International Study of Asthma and Allergies in Childhood (ISAAC II): Rationale and methods. Eur Respir J 2004;24:406-12.
15. Komarow HD, Arceo S, Young M, Nelson C, Metcalfe DD. Dissociation between history and challenge in patients with physical urticaria. J Allergy Clin Immunol Pract 2014;2:786-90.
16. Sánchez-Borges M, González-Aveledo L, Caballero-Fonseca F, Capriles-Hulett A. Review of physical urticarias and testing methods. Curr Allergy Asthma Rep 2017;17:51.
17. Magerl M, Borzova E, Giménez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, et al. The definition and diagnostic testing of physical and cholinergic urticarias-EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy 2009;64:1715-21.

There are 17 citations in total.

Details

Primary Language	Turkish
Subjects	Internal Diseases
Journal Section	ORIGINAL ARTICLES
Authors	Tuğba Arıkoğlu
Publication Date	December 30, 2018
Submission Date	October 5, 2017
Published in Issue	Year 2018 Volume: 12 Issue: 4

Cite

Vancouver	Arıkoğlu T. Çocukluk Çağındaki Kronik Ürtikerli Olguların Etiyolojik Açıdan Değerlendirilmesi. Türkiye Çocuk Hast Derg. 2018;12(4):251-7.

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