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Chronic Spontaneous Urticaria Differs in Children, Adults

Incidence of angioedema, thyroid autoimmunity associated with chronic spontaneous urticaria lower for children than adults

By Physician’s Briefing Staff | October 04, 2021


Pediatric and adult patients with chronic spontaneous urticaria show distinct characteristics, according to a study presented at the annual meeting of the European Academy of Dermatology and Venereology, held virtually from Sept. 29 to Oct 2.

Pelin Kuteyla Can, M.D., from Bahcesehir University in Istanbul, Turkey, and colleagues compared clinical and laboratory parameters, comorbidities, and responses to treatment among 171 pediatric patients and 580 adult patients with chronic spontaneous urticaria.

The researchers observed significant differences between pediatric and adult patients for disease duration (10.0 versus 41.9 days), angioedema (21.8 versus 59.8 percent), anti-thyroid peroxidase (anti-TPO) positivity (8.9 versus 25.4 percent), high C-reactive protein (12.6 versus 41.4 percent), eosinopenia (16.4 versus 39.2 percent), prick test positivity (28.4 versus 39.7 percent), autoimmune thyroiditis (3.3 versus 9.5 percent), and total immunoglobulin E levels (110 versus 142). For pediatric versus adult patients, there were significant differences in the proportion responding to treatments: H1-antihistamines (AH; 57.3 versus 40.1 percent), high doses of H1-AH, combinations of AH or leukotriene antagonists (33.9 versus 25 percent), and omalizumab (7.0 versus 20.8 percent). In pediatric patients, refractoriness to antihistamines was associated with anti-TPO positivity, presence of angioedema, and eosinopenia; in adult patients, the association was significant only for eosinopenia.

"CSU is a common disease found in both children and adults, though there are differences between the two patient populations with respect to medical origins and other coexisting diseases," a coauthor said in a statement. "Our research is focused on identifying these differences to help inform future treatment of chronic spontaneous urticaria and to provide more information on the effects of CSU on children -- something which has previously been neglected in this field of research."

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