Diagnostic Approach to Urticaria and Angioedema in Children

Özçeker, Deniz

doi:https://dx.doi.org/10.5222/j.child.2018.53315

Review

DOI :10.5222/j.child.2018.53315 IUP :10.5222/j.child.2018.53315 Full Text (PDF)

Diagnostic Approach to Urticaria and Angioedema in Children

Urticaria is a disease that can be seen at any age, with sudden onset, itchy redness, and rashes and / or angioedema. Angioedema can not only involve mucous membranes but also the skin. A large number of factors play a role in etiology, but often its etiology can not be detected in children. The most important point in the success of treatment is making the correct diagnosis. For this reason, the diagnosis should be made with patience and a thorough systematic evaluation. Both cases can cause serious concern both in the family and in the patient. Herein, the diagnostic approach to urticaria and angioedema was evaluated in the context of current information.

Keywords: Angioedema, children, urticaria

DOI :10.5222/j.child.2018.53315 IUP :10.5222/j.child.2018.53315 Full Text (PDF)

Çocuklarda Ürtiker ve Anjiyoödeme Tanısal Yaklaşım

Deniz Özçeker

Ürtiker her yaşta görülebilen, ani başlangıçlı, deride kaşıntılı kızarıklıklar ve kabartılarla ve/veya anjiyo ödem ile seyreden bir hastalıktır. Anjiyoödem ise yalnızca deriyi değil mukozaları da tutabilir. Etiyolojide çok sayıda faktör rol oynamakla beraber, çocuklarda neden çoğu kez belirlenemez. Tedavi başarısındaki en önemli nokta, tanının doğru konulmasıdır. Bu nedenle tanı sabırla ve tam bir sistematik değerlendirme ile konulmalıdır. Her iki durumda hem aile de hem de hastada ciddi kaygıya neden olmaktadır. Burada ürtiker ve anjiyoödeme tanısal yaklaşım güncel bilgiler eşliğinde değerlendirildi.

Keywords: Anjiyoödem, çocuk, ürtiker

References

1. Bernstein JA, Lang DM, Khan DA, Craig T, Khan DA, Dreyfus D, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. Practice Parameter. J Allergy Clin Immunol. 2014;133:1270-7. https://doi.org/10.1016/j.jaci.2014.02.036 google scholar
2. Saini SS. Urticaria and angioedema. Adkinson NF, Bochner BS, Burks AW, Busse WW, Holgate ST, Lemanske RF, O’Hehir RE (eds.) Middleton’s Allergy Principles and Practice. Elsevier Saunders, Philadelphia, (2014) s. 575-88. google scholar
3. Kaplan AP, Greaves MW. Angioedema. J Am Acad Dermatol. 2005;53:373-88. https://doi.org/10.1016/j.jaad.2004.09.032 google scholar
4. Greaves MW. Chronic urticaria in childhood. Allergy. 2000;55:309-20. Çocuk Dergisi 2018;18(1):1-9 8 https://doi.org/10.1034/j.1398-9995.2000.00116.x google scholar
5. 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. https://doi.org/10.1111/all.12313 google scholar
6. Greaves MW, Lawlor F. Angioedema: manifestations and management. J Am Acad Dermatol. 1991;25:155- 65. https://doi.org/10.1016/0190-9622(91)70183-3 google scholar
7. Zuraw BL, Bernstein JA, Lang DM, Craing T, Dreyfus D, Hsieh F, et al. A focused parameter update: hereditary angioedema, acquired C1 inhibitor deficiency, and angiotensin-converting enzyme inhibitor-associated angioedema. J Allergy Clin Immunol. 2013;131(6): 1491-15. https://doi.org/10.1016/j.jaci.2013.03.034 google scholar
8. Gaig P, Olona M, Mu-oz Lejarazu D, Caballero MT, Domínguez FJ, Echechipia S, et al. Epidemiology of urticaria in Spain. J Investig Allergol Clin Immunol. 2004;14:214-20. google scholar
9. Kjaer HF, Eller E, Host A, Andersen KE, BinslevJensen C. The prevalence of allergic diseases in an unselected group of 6-year-old children. Pediatr Allergy Immunol. 2008;19:737-45. https://doi.org/10.1111/j.1399-3038.2008.00733.x google scholar
10. Henz BM, Zuberbier T. New developments and perspectives. Hautarzt. 2000;51:302-8. https://doi.org/10.1007/s001050051039 google scholar
11. Bas M, Adams V, Suvorava T, Niehues T, Hoffmann TK, Kojda G. Non allergic angioedema: role of bradykinin. Allergy. 2007;62:842-56. https://doi.org/10.1111/j.1398-9995.2007.01427.x google scholar
12. Zuraw BL. Clinical practice. Hereditary angioedema. N Engl J Med 2008;359:1027-36. https://doi.org/10.1056/NEJMcp0803977 google scholar
13. Pite H, Wedi B, Borrego LM, Kapp A, Raap U. Management of childhood urticaria:current knowlege and practical recommendations. Acta Derm Venereol. 2013;93:500-8. https://doi.org/10.2340/00015555-1573 google scholar
14. 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. https://doi.org/10.1001/archderm.134.3.319 google scholar
15. Sackesen C, Sekerel BE, Orhan F, Kocabas CN, Tuncer A, Adalioglu G. The etiology of different forms of urticaria in childhood. Pediatr Dermatol. 2004;21:102-8. https://doi.org/10.1111/j.0736-8046.2004.21202.x google scholar
16. Ricci G, Giannetti A, Belotti T, Dondi A, Bendandi B, Cipriani F, et al. Allergy is not the main trigger of urticaria in children referred to the emergency room. J Eur Acad Dermatol Venereol. 2010;24:1347-8. https://doi.org/10.1111/j.1468-3083.2010.03634.x google scholar
17. Düzova A, Adalıoğlu G. Ürtiker ve anjiyoödem. Katkı Pediatri Dergisi (Astma ve Alerjik Hastalıklar). 1997;18:789-99. google scholar
18. Volonakis M, Katsaru-Katsari A, Stratigos J. Aetiologic factors in childhood chronic urticaria. Ann Allergy. 1992;69:61-5. google scholar
19. Caffarelli C, Cuomo B, Cardinale F, Barberi, S.,Dascola, CP, Agostinis F, et al. Aetiological factors associated with chronic urticaria in children: a systematic review. Acta Derm Venereol. 2013;93:268-72. https://doi.org/10.2340/00015555-1511 google scholar
20. Jirapongsananuruk O, Pongpreuksa S, Sangacharoenkit P. Visitsunthorn N,Vichyanond P. Identification of the etiologies of chronic urticaria in children: a prospective study of 94 patients. Pediatr Allergy Immunol. 2010;21:508-14. https://doi.org/10.1111/j.1399-3038.2009.00912.x google scholar
21. Sahiner UM, Civelek E, Tuncer A, Yavuz ST, Karabulut E, Sackesen C, et al. Chronic urticaria: Etiology and natural course in children. Int Arch Allergy Immunol. 2011;156:224-30. https://doi.org/10.1159/000322349 google scholar
22. Wedi B, Raap U, Wieczorek D, Kapp A. Urticaria and infections. Allergy Asthma Clin Immunol. 2009;5:10. https://doi.org/10.1186/1710-1492-5-10 google scholar
23. Miyagawa S, Takahashi Y, Nagai A, Yamamoto Y, Nakagawa A, Hori K, et al. Angioedema in neonate with IgG antibodies to parvovirus B19 fallowing intrauterine parvovirus B19 infection. Br J Dermatol. 2000;143:428-30. https://doi.org/10.1046/j.1365-2133.2000.03676.x google scholar
24. Weidenbach H, Beckh KH, Lerch MM, Adler G. Precipitation of hereditary angioedema by infectious mononucleosis. Lancet 1993;342:934-5. https://doi.org/10.1016/0140-6736(93)91985-U google scholar
25. Rais M, Unzeitig J, Grant JA. Refractory exacerbations of hereditary angioedema with associated Helicobacter pylori infection. J Allergy Clin Immunol 1999;103:713-4. https://doi.org/10.1016/S0091-6749(99)70249-6 google scholar
26. Staubach P, Eckhardt-Henn A, Dechene M, Vonend A, Metz M, Mageri M, et al. Quality of life in patients with chronic urticaria is differentially impaired and determined by psychiatric comorbidity. Br J Dermatol. 2006;154:294-8. https://doi.org/10.1111/j.1365-2133.2005.06976.x google scholar
27. Leznoff A, Josse R, Denburg J, Dolovich J. Association of chronic urticaria and angioedema with thyroid autoimmunity. Arch Dermatol. 1983;119:636-40. D. Özçeker, Çocuklarda Ürtiker ve Anjioödeme Tanısal Yaklaşım 9 https://doi.org/10.1001/archderm.1983.01650320010007 google scholar
28. Turktas I, Gokcora N, Demirsoy S, Cakir N, Onal E. The association of chronic urticaria and angioedema with autoimmune thyroiditis. Int J Dermatol. 1997;36: 187-90. https://doi.org/10.1046/j.1365-4362.1997.00187.x google scholar
29. Kılıç G, Guler N, Suleyman A, Tamay Z. Chronic urticaria and autoimmunity in children. Pediatr Allergy Immunol. 2010;21:837-42. https://doi.org/10.1111/j.1399-3038.2010.00986.x google scholar
30. Hergüner S, Kiliç G, Karakoç S, Tamay Z, Tüzün U, Güler N. Levels of depression, anxiety and behavioural problems and frequency of psychiatric disorders in children with chronic idiopathic urticaria. Br J Dermatol. 2011;164;1342-7. https://doi.org/10.1111/j.1365-2133.2010.10138.x google scholar
31. Lin YR, Liu TH, Wu TK, Chang YJ, Chou CC, Wu, HP. Predictive factors of the duration of a first-attck acute urticaria in children Am J Emerg Med. 2011;29:883-9. https://doi.org/10.1016/j.ajem.2010.04.004 google scholar
32. Vena GA, Cassano N, Colombo D, Peruzzi E, Pigatto P; Neo-I-30 Study Group. Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J Am Acad Dermatol. 2006;55:705-9. https://doi.org/10.1016/j.jaad.2006.04.078 google scholar
33. Tarzi MD, Hickey A, Förster T, Mohammadi M, Longhurst HJ. An evaluation of tests used fort he diagnosis and monitoring of C1 inhibitor deficiency: normal serum C4 does exclude hereditary angioedema. Clin Exp Immunol. 2007;149:513-6. https://doi.org/10.1111/j.1365-2249.2007.03438.x google scholar
34. Bowen T, Cicardi M, Farkas H, Bork K, Kreuz W, Zingale L, et al. Canadian 2003 international consensus algorithm for the diagnosis, therapy and management of hereditary angioedema. J Allergy Clin Immunol. 2004;114(3):629-37. https://doi.org/10.1016/j.jaci.2004.06.043 google scholar
35. Bowen T, Cicardi M, Farkas H, Bork K, Longhurst HJ, Zuraw B, et al. 2010 international consensus algorithm for the diagnosis, therapy and management of hereditary angioedema. J Allergy Clin Immunol. 2010;6(1):24. https://doi.org/10.1186/1710-1492-6-24 google scholar
36. Bork K. Hereditary angioedema with normal C1 inhibitor activity including hereditary angioedema with coagulation factor XII gene mutations. Immunol Allergy Clin North Am. 2006;26:709-24. https://doi.org/10.1016/j.iac.2006.09.003 google scholar
37. Ertoy Karagol HI, Yilmaz O, Bakirtas A, Topal E, Demirsoy MS, Turktas I. Angioedema without urticaria in childhood. Pediatr Allergy Immunol. 2013 Nov;24(7):685-90. https://doi.org/10.1111/pai.12118 google scholar
38. Papplardo E, Cicardi M, Duponchel C, Carugati A, Choquet S, Agostoni A, et al. Frequent de novo mutations and exon deletions in the C1 inhibitor gene of patients with angioedema. J Allergy Clin Immunol. 2000;106:1147-54. https://doi.org/10.1067/mai.2000.110471 google scholar
39. Gülbahar O, Gelincik A, Sin A, Güleç M, Yılmaz M et al. Herediter anjiyoödem derleme. Asthma Allegy Immunol. 2010;8:125-38. google scholar

Citations

Copy and paste a formatted citation or use one of the options to export in your chosen format

EXPORT

APA

Özçeker, D. (2018). Diagnostic Approach to Urticaria and Angioedema in Children. Journal of Child, 18(1), 1-9. https://doi.org/10.5222/j.child.2018.53315

AMA

Özçeker D. Diagnostic Approach to Urticaria and Angioedema in Children. Journal of Child. 2018;18(1):1-9. https://doi.org/10.5222/j.child.2018.53315

ABNT

Özçeker, D. Diagnostic Approach to Urticaria and Angioedema in Children. Journal of Child, [Publisher Location], v. 18, n. 1, p. 1-9, 2018.

Chicago: Author-Date Style

Özçeker, Deniz,. 2018. “Diagnostic Approach to Urticaria and Angioedema in Children.” Journal of Child 18, no. 1: 1-9. https://doi.org/10.5222/j.child.2018.53315

Chicago: Humanities Style

Özçeker, Deniz,. “Diagnostic Approach to Urticaria and Angioedema in Children.” Journal of Child 18, no. 1 (Jun. 2025): 1-9. https://doi.org/10.5222/j.child.2018.53315

Harvard: Australian Style

Özçeker, D 2018, 'Diagnostic Approach to Urticaria and Angioedema in Children', Journal of Child, vol. 18, no. 1, pp. 1-9, viewed 6 Jun. 2025, https://doi.org/10.5222/j.child.2018.53315

Harvard: Author-Date Style

Özçeker, D. (2018) ‘Diagnostic Approach to Urticaria and Angioedema in Children’, Journal of Child, 18(1), pp. 1-9. https://doi.org/10.5222/j.child.2018.53315 (6 Jun. 2025).

MLA

Özçeker, Deniz,. “Diagnostic Approach to Urticaria and Angioedema in Children.” Journal of Child, vol. 18, no. 1, 2018, pp. 1-9. [Database Container], https://doi.org/10.5222/j.child.2018.53315

Vancouver

Özçeker D. Diagnostic Approach to Urticaria and Angioedema in Children. Journal of Child [Internet]. 6 Jun. 2025 [cited 6 Jun. 2025];18(1):1-9. Available from: https://doi.org/10.5222/j.child.2018.53315 doi: 10.5222/j.child.2018.53315

ISNAD

Özçeker, Deniz. “Diagnostic Approach to Urticaria and Angioedema in Children”. Journal of Child 18/1 (Jun. 2025): 1-9. https://doi.org/10.5222/j.child.2018.53315

Volume 18, Issue 12018, P. 1-9

TIMELINE

Published Online

30.04.2018

LICENCE

Attribution-NonCommercial (CC BY-NC)

This license lets others remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.

Journal of Child

Review

Diagnostic Approach to Urticaria and Angioedema in Children

Çocuklarda Ürtiker ve Anjiyoödeme Tanısal Yaklaşım

PDF View

References

Citations

EXPORT

APA

AMA

ABNT

Chicago: Author-Date Style

Chicago: Humanities Style

Harvard: Australian Style

Harvard: Author-Date Style

MLA

Vancouver

ISNAD

TIMELINE

LICENCE

SHARE