Prevalence and Risk Factors of Urticaria With a Focus on Chronic Urticaria in Children

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Abstract

Purpose

Limited data is available on the prevalence and risk factors of acute and chronic urticaria in children. Our purpose was to determine the prevalence and identify the risk factors of acute and chronic urticaria in Korean children.

Methods

This population-based study examined 4,076 children (age 4 to 13 years) who were enrolled in the 2015 prospective Seongnam Atopy Project (SAP 2015) in Korea. The parents completed an urticaria questionnaire that included questions regarding the duration, severity, and triggering factors of urticaria. Blood sampling (n=464) was performed to measure vitamin D, total eosinophil count (TEC), and total IgE levels, and skin prick tests (n=503) were done.

Results

The prevalences of the life-time, acute, and chronic urticaria were 22.5%, 13.9%, and 1.8% (chronic continuous urticaria, 0.7%; and chronic recurrent urticaria, 1.1%), respectively. Acute urticaria was significantly associated with allergic diseases and parental history of allergy ( P<0.001), but chronic urticaria was not associated with these clinical factors. There was no significant difference in the 25-hydroxyvitamin D level between subjects with chronic urticaria and controls ( P=0.124). Chronic continuous urticaria was associated with living in a new residence (aOR=2.38, 95% CI=1.02-5.54, P=0.044) and belonging to a family with a high income (aOR=4.24, 95% CI=1.24-14.56, P=0.022).

Conclusions

A total of 1.8% of children were found to have chronic urticaria. Living in a new residence and belonging to a family with a high income increased the risk of chronic continuous urticaria.

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Most cited references 35

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EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria.

T Zuberbier, R Asero, C. Bindslev-Jensen … (2009)

This guideline, together with its sister guideline on the management of urticaria [Zuberbier T, Asero R, Bindslev-Jensen C, Canonica GW, Church MK, Giménez-Arnau AM et al. EAACI/GA(2)LEN/EDF/WAO Guideline: Management of urticaria. Allergy, 2009; 64:1427-1443] is the result of a consensus reached during a panel discussion at the 3rd International Consensus Meeting on Urticaria, Urticaria 2008, a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2)LEN), the European Dermatology Forum (EDF) and the World Allergy Organization (WAO). Urticaria is a frequent disease. The life-time prevalence for any subtype of urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease in quality of life, but also affect performance at work and school and, as such, are members of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors, and pathomechanisms. In addition, it outlines evidence-based diagnostic approaches for different subtypes of urticaria. The correct management of urticaria, which is of paramount importance for patients, is very complex and is consequently covered in a separate guideline developed during the same consensus meeting. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS).

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Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report.

M J Maurer, Nancy Weller, C. Bindslev-Jensen … (2011)

Chronic spontaneous urticaria, formerly also known as chronic idiopathic urticaria and chronic urticaria (CU), is more common than previously thought. At any time, 0.5-1% of the population suffers from the disease (point prevalence). Although all age groups can be affected, the peak incidence is seen between 20 and 40 years of age. The duration of the disease is generally 1-5 years but is likely to be longer in more severe cases, cases with concurrent angioedema, in combination with physical urticaria or with a positive autologous serum skin test (autoreactivity). Chronic spontaneous urticaria has major detrimental effects on quality of life, with sleep deprivation and psychiatric comorbidity being frequent. It also has a large impact on society in terms of direct and indirect health care costs as well as reduced performance at work and in private life. In the majority of patients, an underlying cause cannot be identified making a causal and/or curative treatment difficult. Nonsedating H₁-antihistamines are the mainstay of symptomatic therapy, but treatment with licensed doses relieves symptoms effectively in < 50% of patients. Although guideline-recommended updosing up to fourfold increases symptom control in many patients, a substantial number of patients have only little benefit from H₁ -antihistamines. Consequently, there is a great need for new therapeutic strategies. © 2010 John Wiley & Sons A/S.

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Epidemiology of urticaria: a representative cross-sectional population survey.

T Zuberbier, M Balke, M Worm … (2010)

To investigate the prevalence of urticaria with a focus on chronic urticaria (CU) in a general German population. A questionnaire survey was sent to a representative cross-sectional sample of 13,300 inhabitants of Berlin, Germany, of whom 4093 responded. All respondents who stated ever having had weals or angio-oedema (n=767) were interviewed by telephone. Any interviewees with recent symptoms (within the previous 3 years) were invited for personal investigation including allergy tests; double-blind, placebo-controlled food challenge tests; and quality of life (QOL) assessment. Reported prevalence rates were weighted with regard to age, gender and education so that they were representative of the total population of Berlin. Lifetime prevalence rate of urticaria was 8.8% (95% CI 7.9-9.7%) for all types of urticaria. Lifetime prevalence for CU was 1.8% (95% CI 1.4-2.3%), and prevalence for the 12 months before assessment was 0.8% (95% CI 0.6-1.1%), and 70.3% were female. QOL was markedly reduced for people with CU. Unlike other allergic diseases, there was no increased risk associated with higher education or social status. Prick tests found sensitization of ≥ 1 for type 1 allergens in 39.1% of patients. These were related to comorbidities such as allergic rhinitis or oral allergy syndrome, but were never the underlying cause of CU, as proven by double-blind, placebo-controlled provocation tests. Urticaria is a common disease with marked effects on QOL. The lifetime prevalence of 8.8% for urticaria must be regarded as a lower limit as it is based on conservative prevalence rate calculations, and under-reporting of previous disease can be expected in a questionnaire-based study. © 2010 The Author(s). Journal compilation © 2010 British Association of Dermatologists.

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Author and article information

Journal

Journal ID (nlm-ta): Allergy Asthma Immunol Res

Journal ID (iso-abbrev): Allergy Asthma Immunol Res

Journal ID (publisher-id): AAIR

Title: Allergy, Asthma & Immunology Research

Publisher: The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease

ISSN (Print): 2092-7355

ISSN (Electronic): 2092-7363

Publication date (Print): May 2017

Publication date (Electronic): 03 January 2017

Volume: 9

Issue: 3

Pages: 212-219

Affiliations

[1 ]Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea.

[2 ]CHA University School of Medicine, Seongnam, Korea.

[3 ]Department of Allergy & Clinical Immunology, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea.

[4 ]Department of Dermatology, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea.

[5 ]Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.

[6 ]Department of Pediatrics, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea.

Author notes

Correspondence to: Man Yong Han, MD, Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, 11 Yatap-ro 65-beon-gil, Bundang-gu, Seongnam 13496, Korea. Tel: +82-31-780-6262; Fax: +82-31-780-5239; drmesh@ 123456gmail.com

Article

DOI: 10.4168/aair.2017.9.3.212

PMC ID: 5352572

PubMed ID: 28293927

SO-VID: 91578f40-f88a-4976-acdd-46b87f899f02

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 10 May 2016

Date revision received : 14 July 2016

Date accepted : 19 August 2016

Funding

Funded by: Seongnam Atopy Preventive Project for Children's Happiness;

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Prevalence and Risk Factors of Urticaria With a Focus on Chronic Urticaria in Children

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European Journal of Microbiology and Immunology

Most cited references 35

EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria.

Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report.

Epidemiology of urticaria: a representative cross-sectional population survey.

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Cited by 47

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