Netchiporouk E, et al. - An inspection was carried out of the comorbidities, natural history of chronic urticaria (CU), and its subtypes in children. It also aimed at determining the predictors of resolution. Low resolution rate was disclosed in children with CU. The likelihood of resolution could be speculated via the presence of certain biomarkers (positive basophil activation test (BAT) result and basophil count).

Methods

• The enrollment comprised of pediatric patients with chronic urticaria that presented with hives lasting at least 6 weeks, between 2013 and 2015.
• It was performed at a single tertiary care referral center.
• Data was extracted 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 main measure included the scrutiny of the rate of resolution (defined as absence of hives for at least 1 year with no treatment) and the tie-up with clinical and laboratory markers.

Results

• 139 children younger than 18 years old were recruited.
• Thirty-one patients (20%) presented with inducible urticaria, often cold induced.
• Six children reported autoimmune comorbidity, such as thyroiditis and type 1 diabetes.
• Autoimmune disorders (24 patients [17%]) and CU (17 patients [12%]) were a common occurrence in family members.
• 58% of patients revealed positive BAT results (CD63 levels > 1.8%).
• Patients with positive BAT results (CD63 level >1.8%) exhibited twice the tendency of resolving after 1 year compared with negative BAT results (hazard ratio [HR], 2.33; 95% CI, 1.08-5.05).
• The presence of basophils decreased the tendency of resolution (HR, 0.40; 95% CI, 0.20-0.99).
• There was no connection with age.
• 43 patients reported resolved chronic urticaria, with a rate of resolution of 10.3% per year.
• Higher levels of CD63 were unveiled than 1.8% and the absence of basophils correlated with earlier disease resolution.