Evaluation of clinical and demographic data of children with chronic spontaneous urticaria in Antalya province.

Yıl 2020, Cilt: 13 Sayı: 1, 129 - 135, 21.01.2020

Serkan Filiz

https://doi.org/10.31362/patd.581096

Öz

Purpose: The aim of the study was to
investigate the etiology of chronic urticaria in children and the related
clinical and laboratory findings in our city.

Materials
and methods: 107 patients aged between 7-17 years who were diagnosed with CSU in our clinic
were retrospectively reviewed. Demographic and clinical characteristics were
evaluated. In addition, Urticaria Activity Score (UAS) and Urticaria Control
Test (UCT) were applied to evaluate disease severity.

Results:
A total
of 107 patients with a mean age of 11.99±3.34
were evaluated. Angioedema was associated with 66%
of the patients. The mean duration of urticaria was 13.5±15.10 months. Allergic diseases were associated with 36% of the
patients. 12% of patients had asthma and 21% had allergic rhinitis. In 33% of
cases, inhalant sensitivity and 6.5% of food sensitivity were determined.
Antinuclear antibody (ANA) positivity was found in 16.8%, thyroid autoantibody
was present in 6.5%, urinary tract infection
was found in 3%, helicobacter pylori positivity was found in 1.9% and had
positive stool examination for parasites. The mean UAS7 was 12.96±9.8 and the mean
UCT was 8.43±2.8. No significant difference
was found between the groups in terms of age, gender, presence of angioedema,
duration of disease and ANA positivity when compared with control (n=24) and uncontrolled (n=83) patients (respectively, p=0.842,
p=0.646, p=0.347, p=0.590, p=0.316).

Conclusion:
In
children, atopic diseases, infections, parasitic infestations are present in
the etiology of CSF, where as in most cases the diagnosis remains idiopathic.

Anahtar Kelimeler

Chronic urticaria, childhood, autoimmune thyroiditis, urticaria control test, urticaria activity scoring

Antalya il merkezinde kronik spontan ürtikeri olan çocukların klinik ve demografik verilerinin değerlendirilmesi.

Öz

Amaç: Çalışmada, ilimizdeki çocuklarda KSÜ etiyolojisinde
rol oynayabilecek faktörler ve ilişkili klinik ve laboratuvar bulguların
araştırılması amaçlandı.

Yöntemler: Kliniğimizde KSÜ tanısı alan 7-17
yaş arası 107 hastanın kayıtları retrospektif olarak incelendi.  KSÜ’lü hastaların demografik ve klinik
özellikleri, laboratuvar bulguları, atopi, enfeksiyon, otoimmüniteye yönelik
tetkikleri değerlendirildi. Ek olarak hastalık şiddetinin
değerlendirilmesi için Ürtiker Aktivite Skoru (ÜAS7)  ve hastalık kontrolünün değerlendirilmesi
için Ürtiker Kontrol Testi (ÜKT) uygulandı.

Bulgular:
Ortalama yaşı 11,99.2±3,34 olan 107 hasta çalışmaya dahil edildi. Hastaların
%66’sına anjioödem eşlik etmekteydi. 
Ürtiker ortalama süresi 13,5±15,10 ay idi.  Hastaların %36’sına alerjik hastalıklar eşlik
etmekte idi. Hastaların %12’sinde astım ve %21’inde alerjik rinit öyküsü vardı.
Olguların %33’ünde inhalen duyarlılığı ve 
% 6,5’inde besin alerjen duyarlılığı saptandı. %16,8’inde antinükleer antikor
(ANA) pozitifliği, %6,5’inde tiroid otoantikor varlığı, %3’ünde idrar yolu
enfeksiyonu, %1,9’ unda helikobakter pylori pozitifliği ve gaitada parazit
tespit edildi.ÜAS7 ortalaması 12,96±9,8 ve ÜKT ortalaması 8,43±2,8 idi. ÜKT kontrollü (n=24) ve kontrolsüz
(n=83) olan hastalar karşılaştırıldığında, yaş cinsiyet, anjioödem varlığı,
hastalık süresi ve ANA pozitifliği açısından gruplar arasında anlamlı bir fark
saptanmadı (sırasıyla, p=0,842, p=0,646, p=0,34, p=0,590, p=0,316).

Sonuç: Çocuklarda KSÜ etiyolojisinde
atopik hastalıklar, enfeksiyonlar, paraziter enfestasyonlar yer tutarken çoğu
vakada tanı idiyopatik olarak kalmaktadır.

Anahtar Kelimeler

Kronik ürtiker, çocuklar, otoimmün tiroidit, otoimmün tiroidit, ürtiker kontrol test, ürtiker aktivite skorlaması

Kaynakça

• 1. Zuberbier T, Maurer M: Urticaria: current opinions about etiology, diagnosis and therapy. Acta Derm Venereol 2007;87:196-205 2. 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; 69:868-873. Kaplan AP. Clinical practice: chronic urticeria and angioedema. N Engl J Med 2002; 346: 175-94. 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;133:1270-75. Greaves MW, Tan KT: Chronic urticaria: recent advances. Clin Rev Allergy Immunol 2007;33:134-436. Baiardini I, Giardini A, Pasquali M, Dignetti P, Guerra L, Specchia C et al: Quality of life and patients' satisfaction in chronic urticaria and respiratory allergy. Allergy 2003;58: 621- 37. Maurer M, Ortonne JP, Zuberbier T: Chronic urticaria: a patient survey on quality-of-life, treatment usage and doctor-patient relation. Allergy 2009;64:581-88. van der Valk PG, Moret G, Kiemeney LA: The natural history of chronic urticaria and angioedema in patients visiting a tertiary referral centre. Br J Dermatol 2002;146:110-39. Kozel MM, Mekkes JR, Bossuyt PM, Bos JD: Natural course of physical and chronic urticaria and angioedema in 220 patients. J Am Acad Dermatol 2001;45: 387-9110. Kulthanan K, Jiamton S, Thumpimukvatana N, Pinkaew S: Chronic idiopathic urticaria: prevalence and clinical course. J Dermatol 2007; 34: 294-30111. Azkur D, Civelek E, Toyran M, Msrlolu ED, Erkoolu M, Kaya A, et al. Clinical and etiologic evaluation of the children with chronic urticaria. Allergy Asthma Proc 2016 ;37:450-457 12. 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;156:224-3013. Sakine Işık, Zeynep Arıkan Ayyıldız, Şule Çağlayan Sözmen, Fatih Fırıncı, Pınar Uysal, Özkan Karaman, et al. Kronik ürtikerli olgularımızın etyolojik değerlendirmesi. TURKDERM. 2014;48:13-1614. Weller K, Groffik A, Church MK, Hawro T, Krause K, Metz M et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. 2014;133:1365-7215. Kaplan A, Ferrer M, Bernstein JA, Antonova E, Trzaskoma B, Raimundo Ket al. Timing and duration of omalizumab response in patients with chronic idiopathic/spontaneous urticaria. J Allergy Clin Immunol 2016; 137:474–8116. Choi SH, Baek HS. Approaches to the diagnosis and management of chronic urticaria in children. Korean J Pediatr 2015; 8:159-6417. Volonakis M, Katsarou-Katsari A, Stratigos J: Etiologic factors in childhood chronic urticaria. Ann Allergy 1992; 69:161-518. Chansakulporn S, Pongpreuksa S, Sangacharoenkit P, Pacharn P, Visitsunthorn N, Vichyanond P et al. The natural history of chronic urticaria in childhood: a prospective study.J Am Acad Dermatol. 2014;71:663-819. Sackesen C, Sekerel BE, Orhan F, Kocabas CN, Tuncer A, Adalioglu G. The etiology of different forms of urticaria in childhood. Pediatr Dermatol 2004;21:102-820. Jirapongsananuruk O, Pongpreuksa S, Sangacharoenkit, P, Visitsunthorn N, Vichyanond P: Identification of the etiologies of chronic urticaria in children: a prospective study of 94 patients. Pediatr Allergy Immunol 2010; 21: 508–51421. Brunetti L, Francavilla R, Miniello VL, Platzer MH, Rizzi D, Lospalluti ML, et al. High prevalence of autoimmune urticaria in children with chronic urticaria. J Allergy Clin Immunol 2004; 114: 922–92722. Leznoff A, Sussman GL: Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity: a study of 90 patients. J Allergy Clin Immunol. 1989; 84: 66–7123. Cebeci F, Tanrikut A, Topcu E, Onsun N, Kurtulmus N, Uras AR. Association between chronic urticaria and thyroid autoimmunity. Eur J Dermatol 2006; 16: 402–524. Harris A, Twarog FJ, Geha RS: Chronic urticaria in childhood. natural course and etiology. Ann Allergy 1983; 51: 161–525. 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; 43:259-6326. Demirci M, Yildirim M, Aridogan BC, Baysal V, Korkmaz M. Tissue parasites in patients with chronic urticaria. J Dermatol 2003; 30: 777-81. 27. Arik Yilmaz E, Karaatmaca B, Sackesen C, Sahiner UM, Cavkaytar O, Sekerel BE, et al. Parasitic infections in children with chronicspontaneous urticaria. Int Arch Allergy Immunol 2016;171:130-528. Poddighe D, De Amici M, Marseglia GL. Spontaneous (autoimmune) chronic urticaria in children: Current evidences, diagnostic pitfalls and therapeutic management. Recent Pat Inflamm Allergy Drug Discov 2016;10:34-9