Chronic spontaneous urticaria in pediatric age

I. Cunha, E. Gomes
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Abstract

Introduction: Chronic spontaneous urticaria is characterized by emergence of pruritic maculopapular cutaneous lesions recurring for more than six weeks, without known triggering factor. Association with autoimmunity is sometimes present, with urticaria preceding the onset of autoimmune disease.Clinical case: A five-year-old female with a personal history of allergic asthma and family history of thyroid disease was referred to the Immunoallergology consultation for cutaneous complaints compatible with urticaria with more than three years of evolution. Inducible urticaria forms were excluded. Analytical study revealed positive antinuclear antibodies with a 1/320 titer and positive basophil activation test after stimulation with autologous serum. Control of cutaneous manifestations was achieved with full dose antihistaminic H1. Conclusion: Chronic spontaneous urticaria associated with autoimmunity is rare in children. Clinical follow-up should be maintained to evaluate disease control and enable early recognition of other autoimmunity manifestations.
儿童期慢性自发性荨麻疹
慢性自发性荨麻疹的特点是出现瘙痒性丘疹性皮肤病变,反复出现超过6周,没有已知的触发因素。有时与自身免疫有关,荨麻疹先于自身免疫性疾病的发作。临床病例:一名五岁女性,个人有过敏性哮喘史,家族史有甲状腺疾病,因皮肤疾患与三年以上演变的荨麻疹相一致而就诊于免疫过敏症科。排除了诱导型荨麻疹。分析结果显示,经自体血清刺激后,抗核抗体呈1/320滴度阳性,嗜碱性粒细胞活化试验阳性。用全剂量的抗组胺药H1控制皮肤表现。结论:儿童慢性自发性荨麻疹合并自身免疫是罕见的。应保持临床随访,以评估疾病控制情况,并尽早识别其他自身免疫表现。
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