Hospital admissions for urticaria in a pediatric emergency department of a tertiary care hospital

• Inês Filipa da Costa Farinha ^[1] ; Helena Sofia Pires Aguiar Pereira ^[1] ; Sónia Cristina Gaspar de Lemos ^[2] ; Emília Maria Antunes Gomes de Faria ^[1] ; Fernanda Maria Pereira Rodrigues ^[3]
  1. [1] Allergy and Clinical Immunology Department, Coimbra Hospital and University Center, Coimbra, Portugal.
  2. [2] Allergy Unit, Pediatric Hospital, Coimbra Hospital and University Center, Coimbra, Portugal.
  3. [3] Emergency Service and Infeciology Unit, Pediatric Hospital, Coimbra Hospital and University Center, Coimbra, Portugal; University Clinic of Pediatrics, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal.

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• Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 51, Nº. 3, 2023, págs. 117-123
• Idioma: inglés
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• Resumen

  • Background: Urticaria is a common disorder, estimated to affect 2.1 to 6.7% of children and adolescents, and is a frequent cause of emergency department (ED) admissions.

    Methods: The aim of this study was to retrospectively characterize the clinical features of children and adolescents with a diagnosis of urticaria, evaluated in a tertiary care pediatric ED between 2015 and 2019. Statistical analysis was performed using IBM SPSS Statistics®, version 27.0.

    Results: A total of 2254 episodes of urticaria were counted with 98.1% corresponding to acute urticaria (AU). A suspected trigger factor was identified in 51.6% of the episodes, namely infections (27.8%), drugs (9.9%) and food (7.6%). From these episodes, excluding infections, only 59.2% were referred to an Allergy Consultation for further study, with only 18.8% (drug) and 28.3% (food) confirmed as the AU trigger. Of the 43 episodes of chronic urticaria (CU), 79% were referred to consultation, with 23 being diagnosed with chronic spontaneous urticaria, 8 with inducible urticaria and 3 with both entities. Older age (p < 0.001), personal history of atopy (p = 0.019) and angioedema (p = 0.003) were factors associated with CU, while the presence of other accompanying symptoms (p = 0.007) was associated with AU. Older age (OR = 1.2; p < 0.001) and the presence of angioedema (OR = 2.7; p = 0.007) were identified as independent factors for CU.

    Conclusion: The majority of episodes corresponded to AU. Infections were the main suspected trigger, followed by drugs and food, with an overall confirmation rate ranging from 18 to 30%, highlighting the importance of an allergologic follow-up evaluation.