Çocukluk Çağında Ürtiker ile Çocuk Acil Polikliniğine Başvuran Hastaların Klinik ve Etiyolojik Özelliklerinin Araştırılması

Abstract

Urticaria is a common skin condition and is one of the major causes for the admissions to the emergency room. We aimed to identify the common causes of urticaria, clinical characteristics of patients and determine the treatment choices and measures to prevent the recurrent admissions to the emergency room for urticaria. The urticaria code, L50, in the ICD system is used for the selection of children with the diagnosis of urticaria during one year (1 January 2013 - 31 December 2013). Medical records concerning history and laboratory tests as well as direct phone call made with parents for the etiology of urticaria were noted. The causes of urticaria were classified as infections, drugs, foods, insect stings, blood products, vaccines and others. The diagnosis of infection was based on symptoms and physical examination whereas the diagnosis of food/drug/venom allergy was based on the history of anaphylaxis, sIgE levels, skin prick tests and challenge tests. A total of 842 children had a diagnosis of urticaria, L50 code. We obtained data concerning urticaria from 465 children [5 yrs (2.0-9.1, median (IQR)]. The majority of the children (88%) were referred for urticaria for the first time and the remaining cases had recurrent urticaria (11%) and chronic urticaria (1%). The triggering factors as infections (18%), drugs (14%), foods (8%), insect stings (3%), blood products (0,4%), vaccines (0,4%), dye (0,4%) and swimming pool (0,4%) were reported as the cause of urticaria. In 53,5% of patients, probable etiologic factor for urticaria could not be identified. After the allergic work-up, the diagnosis of food allergy (n=11), drug allergy (n=8) and venom allergy (n=1) were made in 3,2% of children with urticaria. Urticaria is a distressing disease due to fear of life-threatening condition during childhood and an important cause of admissions to emergency room. Infection is determined as the most frequent cause of urticaria followed by food and drug allergies as second and third causes of urticaria in childhood.