Pharmacologic Management of Chronic Urticaria in Pediatric Patients: The Gap Between Guidelines and Practice

AbstractChronic urticaria is an uncommon disorder in children but can present considerable morbidity, as well as frustration for the healthcare provider and parent. The prevalence is 0.1 –0.3% but can vary considerably by country. Chronic spontaneous urticaria (no identifiable cause) is responsible for 70–80% of chronic urticaria, about half of this due to a subtype called chronic autoimmune urticaria identified by the presence of autoantibodies to IgE or the IgE receptor. Chron ic urticaria that is triggered by external physical stimuli is called chronic inducible urticaria and is present in another 15–20%. Allergies, infection, and other underlying diseases such as thyroid disease, celiac disease, orHelicobacter pylori infection cause a minor proportion of cases. Chronic urticaria has considerable impact on quality of life and healthcare costs. An adverse impact on quality of life is more prevalent in older children and adolescents and can be comparable to other diseases of childhood such as diabetes and epilepsy. Healthcare costs can be 50% higher than the national estimates for healthy patients and include more hospitalizations, longer duration of hospitalizations, and more emergency department (ED) and outpatient visits. Allergic and autoimmune diseases can be comorbidities that add to healthcare utilization. Resolution can take years. Guidelines are available for diagnosis and treatment. A good history is the key to identifying the cause. Minimal laboratory tests ...
Source: Pediatric Drugs - Category: Pediatrics Source Type: research