Abstract

Objective: Acute urticaria is one of the most common causes of admission to hospitals in children. The aim of the study
is to evaluate the etiology of acute urticaria in patients who admitted to pediatric allergy outpatient clinics.

Material and Methods: The patients who were diagnosed as acute urticaria in pediatric allergy outpatient clinics
between January 1, 2016 and December 31, 2016 were included in the study. Patient information was recorded
retrospectively from medical files.

Results: In this study, 469 patients with acute urticaria were evaluated. The median (min-max) age of the patients was
7 years (2 months-18 years), and 48.8 % of them were male. Angioedema was accompanying in 20 % of the patients.
Recurrent acute urticaria was seen in 33.5 % (n = 157) of the patients. In the history, infections were the triggers in
37.5 % (n=176) of the patients, drugs in 17.9 % (n=84), food in 10.9 % (n=51), insect bites in 3.2 % (n=15), and 0.2 %
(n=1) of them had the vaccine. When the patients were evaluated with the medical histories, physical examination and
laboratory findings; triggers could not be detected in 59 % (n=276) and these patients were diagnosed as idiopathic
acute urticaria. Infections (37.5 %; n=176) were in the first place in patients with triggers. Food and drug allergies were
confirmed in only one patient each. Considering the etiological distribution according to age groups, it was seen that
idiopathic acute urticaria was more common in the 12-18 age group and infection-associated acute urticaria in the
group under 2 years old (p=0.009).

Conclusion: Mostly, triggers cannot be found in children who apply to the allergy clinic due to acute urticaria. In patients
who can be identified triggers, infections are in the first place. However, patients’ clinical histories may also include food or
drug(s) as a suspected trigger, and it is important to evaluate these patients with diagnostic allergy tests. Thus, misdiagnosis
of patients and unnecessary food or drug restrictions would be prevented.

Keywords: Acute Urticaria, Children, Etiology, Infection, Trigger

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. Zuberbier T, Maurer M. Urticaria: current opinions about etiology, diagnosis and therapy. Acta Derm Venereol 2007;87:196-205.
  3. Zuberbier T, Balke M, Worm M, Edenharter G, Maurer M. Epidemiology of urticaria: a representative cross sectional population survey. Clin Exp Dermatol 2010;35: 869-73.
  4. Liu TH, Lin YR, Yang KC, Chou CC, Chang YJ, Wu HP. First attack of acute urticaria in pediatric emergency department. Pediatr Neonatol 2008;49:58-64.
  5. Sackesen C, Sekerel BE, Orhan F, Kocabas CN, Tuncer A, Adalioglu G. Theetiology of different forms of urticaria in childhood. Pediatr Dermatol 2004;21:102–8.
  6. Ricci G, Giannetti A, Belotti T, Dondi A, Bendandi B, Cipriani F, et al. Allergy is not themain trigger of urticaria in children referred to the emergency room. J Eur Acad Dermatol Venereol 2010;24:1347–8.
  7. Zuberbier T, Ifflander J, Semmler C, Henz BM. Acute urticaria: clinical aspects and therapeutic responsiveness. Acta Derm Venerol 1996;76:295–7.
  8. Konstantinou GN, Papadopoulos NG, Tavladaki T, Tsekoura T, Tsilimigaki A, Grattan CEH. Childhood acute urticaria in northern and southern Europe shows a similar epidemiological pattern and significant meteorological influences. Pediatr Allergy Immunol 2011;22:36–42.
  9. Kaplan AP. Urticaria and Angioedema. In: Middleton E, Ellis EF, Yunginger JW, Reed CE, Adkinson NF, Busse WW (Eds.). Allergy Principles and Practice. Seventh ed. St. Louis: Mosby; 2008 p.1063-81.
  10. Ogunbiyi AO, Owoaje E, N dahi A. Prevalence of skin disorders in school children in Ibadan, Nigeria. Pediatr Dermatol 2005; 22: 6-10.
  11. Saçar H, Saçar T. prevalence of childhood dermatoses. Turkderm 2010; 44: 132-7.
  12. Mortureux P, Léauté-Labrèze C, Legrain-Lifermann V, Lamireau T, Sarlangue J, Taïeb A. Acute urticaria in infancy and early childhood: a prospective study. Arch Dermatol 1998;134:319-23.

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How to cite

1.
Arı H, Güvenir H, Toyran M, Civelek E, Büyüktiryaki B, Giniş T, et al. Etiological Evaluation of Acute Urticaria in Children. Turk J Pediatr Dis [Internet]. 2023 Jan. 30 [cited 2025 May 25];17(1):13-8. Available from: https://turkjpediatrdis.org/article/view/999