The Etiology of Different Forms of Urticaria in Childhood

Abstract

Urticaria is a common disease in children. In contrast to the ease of its diagnosis, etiologic factors are often difficult to determine. In order to study whether differences exist among various forms of urticaria in childhood and whether the patterns of different types of urticaria differ between adults and children, we extensively studied the possible causes of urticaria in children. Fifty-four children (23 girls and 31 boys; ages 1-19 years) with various forms of urticaria were included in the study. In all cases, questions about food allergies, food additive intolerance, drug intake, signs of infection, causes of physical urticaria, insect bites, and personal and family history of atopy were asked. Clinical characteristics of the disease, such as duration, recurrence, and associated angioedema and symptoms of anaphylaxis were also investigated. Detailed laboratory tests, including serologic, autoimmune, and allergic analyses, were conducted to reveal the probable etiologies of urticaria. Of the study patients, 68.5% and 31.5% were diagnosed as having acute and chronic urticaria, respectively. The patient group with chronic urticaria was older and included more boys than the acute group. In the acute urticaria group, infection was the most frequently documented cause (48.6%), followed by drugs (5.4%), and food allergies (2.7%), whereas in chronic urticaria, physical factors were the leading cause (52.94%). The most frequently documented infection was urinary tract infection, followed by serologically determined infections of Chlamydia pneumoniae and Helicobacter pylori. In this study we found indications that infections were frequently associated with urticaria, which suggests that urticaria management should include a survey of certain infectious agents in addition to a detailed history.

Recidiva de urticária crônica decorrente de reinfecção por Helicobacter pylori

“…Growing evidence of the involvement of Helicobacter pylori in different extra intestinal conditions, among them the ChU, have been accumulated in the last years, and taking into consideration its high prevalence in developing countries, the investigation of Helicobacter pylori infection seems to be justified in patients with ChU with no established etiology, even for those with no gastrointestinal symptoms, as reported by Sackensen et al (17) . In the present report, because of the history of epigastric pain, the extensive laboratory investigation failing to detect the etiology of the ChU and the persistence of the urticarial lesions, an upper endoscopy was performed, which showed gastritis in association with Helicobacter pylori.…”

“…The etiologic investigation of the patients with different forms of urticaria showed that 3 of the 17 patients with ChU who had no gastrointestinal symptoms were positive for Helicobacter pylori. One of these patients, a 13 year old male adolescent, showed resolution of the ChU after eradication of the bacteria (17) .…”

Chronic Urticaria in Children: An Update about Etiology

“…Recurrent respiratory and urinary infections have been associated with chronic urticaria [9]. Up to some extent Chlamydia and H. helicobacter pylori are also play role in children with chronic urticaria observed that the infections in children are third most common etiology of chronic urticaria [10]. Infection has been contributed about 7% to 13% as etiological factor of chronic urticaria in children [11].…”

Malaria - the Master Masquerader

“…), bacterial (Streptococci, Helicobacter etc. ), fungal and protozoal have been implicated as triggers of acute urticaria [4].Classically malaria, is not associated with skin rash, petechial haemorrhages in skin and mucous membrane but they occur rarely in falciparum malaria. A few case reports, from India cite instances of Plasmodium vivax malaria presenting with acute urticaria [5,6].…”