Netchiporouk E, et al. - The authors intended to discern the comorbidities, natural history of chronic urticaria (CU), and its subtypes in children and aimed at determining the predictors of resolution. The results displayed low resolution rate in the study cohort. It was reported that the presence of certain biomarkers (positive basophil activation test result and basophil count) could assist in speculating the tendency of resolution.

Methods

• The enrollment comprised of pediatric patients with chronic urticaria, having hives lasting at least 6 weeks.
• This study was carried out between 2013 and 2015 at a single tertiary care referral center.
• Data were cumulated with regard to the disease activity, comorbidities, physical triggers, BAT results, complete blood cell count, C-reactive protein levels, thyroid-stimulating hormone levels, and thyroid peroxidase antibodies.
• The primary outcome included a scrutiny of the rate of resolution (defined as absence of hives for at least 1 year with no treatment) and the connection with clinical and laboratory markers.

Results

• This trial enrolled 139 children, younger than 18 years old.
• Thirty-one patients (20%) presented with inducible urticaria, most commonly cold induced.
• Autoimmune comorbidity, such as thyroiditis and type 1 diabetes was reported in 6 children.
• Autoimmune disorders (24 patients [17%]) and CU (17 patients [12%]) appeared as a common occurrence, in family members.
• 58% of patients displayed positive BAT results (CD63 levels > 1.8%).
• Patients with positive BAT results (CD63 level >1.8%) were found to be twice as likely to resolve after 1 year than with negative BAT results (hazard ratio [HR], 2.33; 95% CI, 1.08-5.05).
• On the other hand, a decrease was noted in the tendency of resolution (HR, 0.40; 95% CI, 0.20-0.99) due to the presence of basophils.
• The findings did not reveal any connection with age.
• It was determined that chronic urticaria resolved in 43 patients, with a rate of resolution of 10.3% per year.
• A link was brought to light between the levels of CD63 higher than 1.8% and absence of basophils with earlier disease resolution.