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

IF 4.2 Q3 Pharmacology, Toxicology and Pharmaceutics
D. Poddighe, M. De Amici, G. Marseglia
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引用次数: 26

Abstract

BACKGROUND 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. OBJECTIVE 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. RESULTS AND CONCLUSION 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.
儿童自发性(自身免疫性)慢性荨麻疹:目前的证据,诊断缺陷和治疗管理。
背景:儿科慢性荨麻疹的泌尿学诊断是相当具有挑战性的,因为很少有病例可以与特定的触发因素相关联。因此,超过50%的儿童慢性荨麻疹被标记为特发性。一些证据支持30-40%的成人特发性(或自发性)慢性荨麻疹患者的自身免疫性发病机制,其中自身免疫性慢性荨麻疹的诊断包括体内和体外试验,显示主要存在针对高亲和力IgE受体的自身抗体。目的收集和分析儿童自身免疫性慢性荨麻疹诊断和治疗的所有现有证据,包括最新进展和专利。结果与结论:大多数儿童研究仅依靠自体血清皮肤试验来证明自身免疫性荨麻疹。对儿童自身免疫性慢性荨麻疹的完整诊断评估,证明了抗体介导的疾病机制,可能改善儿童自发性(自身免疫性)慢性荨麻疹的治疗管理,支持在对一线治疗有抵抗力的病例中使用omalizumab而不是免疫抑制治疗。
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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
0
期刊介绍: Recent Patents on Inflammation & Allergy Drug Discovery publishes review articles by experts on recent patents in the field of inflammation and allergy drug discovery e.g. on novel bioactive compounds, analogs and targets. A selection of important and recent patents in the field is also included in the journal. The journal is essential reading for all researchers involved in inflammation and allergy drug design and discovery.
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