Spontaneous (Autoimmune) Chronic Urticaria in Children: Current Evidences, Diagnostic Pitfalls and Therapeutic Management

Recent Patents on Inflammation & Allergy Drug Discovery
Dimitri PoddigheGian L Marseglia

Abstract

Etiologic diagnosis of pediatric chronic urticaria is quite challenging, as few cases can be associated to specific triggers. Thus, more than 50% of chronic urticaria in children are labeled as idiopathic. Several evidences supported an autoimmune pathogenesis in 30-40% of patients with idiopathic (or spontaneous) chronic urticaria in adults, where the diagnosis of autoimmune chronic urticaria included in vivo and in vitro tests, revealing the presence of autoantibodies against high-affinity IgE receptors mainly. This review aimed at collecting and analyzing all the available evidences on the diagnosis and treatment of autoimmune chronic urticaria in children, including most recent developments and patents. Most pediatric studies relied on autologous serum skin test only, in order to evidence autoimmune urticaria. A complete diagnostic assessment of pediatric autoimmune chronic urticaria, demonstrating an antibodymediated mechanism of disease, might ameliorate the therapeutic management of spontaneous (autoimmune) chronic urticaria in children, supporting the use of omalizumab rather than immuno-suppressive therapy in cases resistant to the firstline treatments.

Citations

Aug 3, 2017·BMJ Case Reports·Dimitri Poddighe
Apr 10, 2019·Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology·Dimitri PoddigheMaikesh Assylbekova
Oct 11, 2017·BMJ Case Reports·Dimitri Poddighe
May 7, 2020·Pediatric Dermatology·Ahmed Al KamzariReem Abdwani
Jan 16, 2021·Journal of Clinical Medicine·Maddalena NapolitanoCataldo Patruno

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