Atopy Does Not Influence the Clinical Outcome of Acute Urticaria: A Retrospective Study.

BACKGROUND: Acute urticaria (AU) may be associated with atopy, but the relationship between atopic status and the clinical features of the disease has not been fully described. OBJECTIVES: The aim of the study was to determine the proportion of atopy in AU patients and to see whether atopy is related to the clinical characteristics of AU and whether it has an impact on the outcome of the disease. MATERIALS AND METHOD: A retrospective analysis of patients with AU was performed. Demographic data, clinical features, and laboratory results were compared and analyzed between the atopic and non-atopic AU (napAU). RESULTS: In total, 139 participants were included. 54 (38.8%) patients were atopic AU (apAU) and 85 (61.2%) were napAU. Compared with napAU patients, apAU patients were more likely to have anaphylaxis, higher levels of C4, and lower levels of antistreptolysin. There were no significant differences between the two groups in terms of other clinical features, laboratory tests, the natural course of the disease, or disease outcomes. CONCLUSION: Atopy does exist in some patients with AU, and AU patients with an atopic background are at higher risk for anaphylaxis. Atopy does not influence the clinical outcome of AU and is not correlated with other clinical features and laboratory results of AU.

Acute Urticaria: Symptoms, Causes, and Evaluation of Phenotypes Prone to Chronicity.

INTRODUCTION: Urticaria is a condition that is characterized by the development of wheals (hives), angioedema, or both. If symptoms persist for less than 6 weeks, it is classified as acute urticaria (AU), and if they persist for longer than 6 weeks, it is classified as chronic urticaria (CU). Disease activity is evaluated using validated patient-reported outcome measures (PROMs) such as the 7-day urticaria activity score (UAS-7) and urticaria control test (UCT). In this study, we aimed to determine whether there was a difference between patients with chronic and recovered urticaria in terms of age, sex, symptoms, disease severity, disease control, and triggering factors by following patients with AU for 6 months. METHODS: The routine tests were requested at the first admission of the patients. If previously examined, anti-thyroid peroxidase (anti-TPO), anti-nuclear antibody, etc., were recorded. After the first examination, the patients were evaluated again using a visual analog scale (VAS), UCT, UAS-7, and medication scores (MSs) in the 1st, 3rd, and 6th months. RESULTS: One hundred nine (F/M: 80/29) patients were included in the study. Twenty-seven patients had a previous history of AU, 22 of these patients were evaluated as having recurrent AU, and five became chronic during follow-up. Urticaria continued in 22 of 82 patients who presented with first-attack AU in the 3rd month and 17 in the 6th month. We had a chronicity rate of 24.7%. It was determined that having positive anti-TPO increased the risk of CU 1.69 times. A statistically significant improvement was found in the mean VAS, UCT, UAS-7, and MSs evaluated in the 1st, 3rd, and 6th months of patients with CU compared with baseline. CONCLUSION: AU is a common disease and usually heals in a short time without becoming chronic. Studies on the causes of chronicity are limited. Testing anti-TPO in patients presenting with AU may be useful in terms of disease course and risk of chronicity.

Detection and Analysis of Commonly Used Infection Indicators in Patients with Acute Urticaria.

INTRODUCTION: In this study, we investigated the correlation and clinical significance of peripheral blood leukocytes, neutrophils, C-reactive protein (CRP), and procalcitonin (PCT) in patients with acute urticaria. METHODS: Complete blood count with differential, CRP, and PCT tests were conducted on patients with acute urticaria. A total of 614 patients with acute urticaria were divided into three groups: the first group consisted of patients with elevated leukocyte and neutrophil count, the second group consisted of patients with normal leukocyte and neutrophil count, and the third group consisted of patients with abnormal leukocyte and neutrophil count. A correlation analysis was conducted to investigate the levels of leukocytes, neutrophils, CRP, and PCT in the three groups. RESULTS: The results of Kruskal-Wallis' nonparametric test revealed statistically significant variations in leukocytes, neutrophils, CRP, and PCT among the three groups (p < 0.001). However, CRP and PCT showed no statistically significant differences between the second and third groups (p < 0.001, p = 0.0041, p = 0.0032). Additional multiple comparisons in Spearman correlation analysis indicated statistically significant differences (p = 0.55). Across all groups, there was a statistically significant difference in the correlation between CRP-PCT and leukocytes-neutrophils (p = 0.53). CONCLUSION: Leukocytes and neutrophils are sensitive to the impact of medications and stress on the body. Combining CRP and PCT, as well as routine blood test, may be a comprehensive assessment of infection presence and severity in patients, providing guidance for antibiotic treatment.

Hospital admissions for urticaria in a pediatric emergency department of a tertiary care hospital.

BACKGROUND: Urticaria is a common disorder, estimated to affect 2.1 to 6.7% of children and adolescents, and is a frequent cause of emergency department (ED) admissions. METHODS: The aim of this study was to retrospectively characterize the clinical features of children and adolescents with a diagnosis of urticaria, evaluated in a tertiary care pediatric ED between 2015 and 2019. Statistical analysis was performed using IBM SPSS Statistics®, version 27.0. RESULTS: A total of 2254 episodes of urticaria were counted with 98.1% corresponding to acute urticaria (AU). A suspected trigger factor was identified in 51.6% of the episodes, namely infections (27.8%), drugs (9.9%) and food (7.6%). From these episodes, excluding infections, only 59.2% were referred to an Allergy Consultation for further study, with only 18.8% (drug) and 28.3% (food) confirmed as the AU trigger. Of the 43 episodes of chronic urticaria (CU), 79% were referred to consultation, with 23 being diagnosed with chronic spontaneous urticaria, 8 with inducible urticaria and 3 with both entities. Older age (p < 0.001), personal history of atopy (p = 0.019) and angioedema (p = 0.003) were factors associated with CU, while the presence of other accompanying symptoms (p = 0.007) was associated with AU. Older age (OR = 1.2; p < 0.001) and the presence of angioedema (OR = 2.7; p = 0.007) were identified as independent factors for CU. CONCLUSION: The majority of episodes corresponded to AU. Infections were the main suspected trigger, followed by drugs and food, with an overall confirmation rate ranging from 18 to 30%, highlighting the importance of an allergologic follow-up evaluation.

Urticaria relapse after mRNA COVID-19 vaccines in patients affected by chronic spontaneous urticaria and treated with antihistamines plus omalizumab: A single-center experience.

Urticaria is a disease characterized by wheals and/or angioedema. Chronic spontaneous urticaria (CSU) occurs for longer than 6 weeks and appears independently of any identifiable exogenous stimulus. During the vaccination campaign for Coronavirus disease 2019 (COVID-19) pandemic, several cutaneous adverse events have been described, among which urticaria lasting less than 6 weeks (acute urticaria, AU). AU due to vaccines can be IgE or non-IgE mediated; the former typically develop within 4 h of drug exposure, the latter occurs later and the mechanism is unclear. In this retrospective study we analyzed the frequency and clinical characteristics of urticaria occurring after COVID-19 vaccine (post-vaccination urticaria relapse) in adult CSU patients treated with antihistamine and omalizumab, and in clinical remission.

Acute urticaria in children: from pediatric Emergency Department to allergology consultation at a Central Hospital.

Summary: Background. Acute urticaria is a common condition in the pediatric emergency department (ED) and no data is available in Portugal. Objective. We aimed to characterize the prevalence, etiology and management of acute urticaria in children presenting at an ED of a portuguese central hospital and report the follow-up investigation when drug or food allergy was suspected.Methods. Retrospective study of clinical records from children admitted to the ED with acute urticaria during one year period. Results. 250 children were included, mean age of 7.4 ± 4.9 years (0-17 years). The most frequently suspected etiological factors were infections (22%), foods (12%), insect bites (9%) and drugs (8%), of which, upper respiratory tract infections, seafood and ß-lactam antibiotics were the most frequent. In 44% of cases, the etiology of urticaria was not determined. After ED discharge, of the 50 patients with suggestive drug or food allergy, only 48% were sent to allergological workup and the allergy confirmed in 6 of them (2.4% of the 250 children). Conclusions. These data suggest that allergy is not the main trigger of acute urticaria in ED children, but when suspected, reference to an allergy department to complete allergological workup was insufficient.

Acute urticaria in children: course of the disease, features of skin microbiome.

Introduction: Quantitative and qualitative changes in the microbiome of the skin affect the emergence and course of allergic diseases, in particular, of acute urticaria. Aim: To investigate the taxonomic composition of the skin microbiota in children with acute urticaria and to study its effect on the course of the disease. Material and methods: In total, 75 children with diagnosed acute urticaria at the age of 7--14 years were examined. The average age of children was 10.83 ±0.95, of which 44 (58.7%) were boys, and 31 (41.3%) were girls. The control group consisted of 30 virtually healthy children of the appropriate age, of whom 16 (53.3%) were boys, and 13 (46.7%) were girls. Results: Regardless of the severity of the disease, the examined children suffering from acute urticaria had sensitization in history with a significant prevalence of food sensitization (p < 0.05). The occurrence of a severe episode of acute urticaria is associated with allergens of drug origin in 52.6% of cases and the action of unidentified triggers in 47.4% of cases. In children with acute urticaria, S. epidermidis, S. aureus, bacteria of the genus Peptococcus, and Peptostreptococcus dominated on a non-affected skin area, while for the affected skin area, the Propionibacterium, S. aureus, S. epidermidis, bacteria of the genus Peptococcus, Propionibacterium, and Peptostreptococcus were denoted as dominating. Conclusions: High frequency of S. aureus detection on affected and non- affected skin areas in children with acute urticaria is a predictor of the disease severity.

Evaluation of urticaria patients before and during the period of the COVID-19 pandemic: A retrospective study.

The COVID-19 pandemic is the most serious health crisis facing the modern world; hospital admissions have risen dramatically. Urticaria is characterized by itchy edematous papules/plaques, angioedema, and involvement of one or both of the deep dermis or subcutis. We investigated the effect of the COVID-19 pandemic on the incidence of acute and chronic urticaria, the proportions of urticaria patients among all dermatology patients before and after the onset of the pandemic, and age and sex characteristics. About 57 patients diagnosed with urticaria before the onset of the COVID-19 pandemic in December 2019 and January and February 2020 at the Dermatology Polyclinic of Beysehir State Hospital, and 25 patients diagnosed within 3 months (March-May 2020) after the onset of the pandemic, were included. We retrospectively recorded age, sex, and the duration of the disease. Patients were divided into those with acute and chronic urticaria using the EAACI/GA(2)/LEN/EDF/WAO guidelines and data obtained before and after the onset of the pandemic were compared. Fifty-one (62.2%) patients were female and the mean patient age was 40.88 ± 17.38 years. We found no significant difference in the mean age or sex distribution before and after the onset of the pandemic (P = .341; P = .604). The proportion of urticaria patients (1.6%) among all dermatology patients treated in a 3-month period after the onset of the pandemic was higher than that before the pandemic (1.19%; P < .001). During the pandemic, the acute urticaria rate was significantly higher than before the pandemic (P = .002). The urticaria rate (particularly that of acute disease) increased during the COVID-19 pandemic. Dermatologists should consider whether patients with urticaria might be infected with COVID-19.

A randomized controlled trial of adding intravenous corticosteroids to H1 antihistamines in patients with acute urticaria.

BACKGROUND: Acute urticaria is a common dermatological condition in emergency departments (EDs). The main therapy involves controlling pruritus with antihistamines. Although guidelines have promoted the use of corticosteroids in addition to H1 antihistamines, well-designed clinical trials evaluating this approach are scarce. METHODS: Adult ED patients with acute urticaria and a pruritus score > 5 on a visual analog scale (VAS) were randomized into three groups: (i) IV chlorpheniramine (CPM) treatment, (ii) IV CPM and IV dexamethasone (CPM/Dex) and (iii) IV CPM and IV dexamethasone with oral prednisolone as discharge medication for 5 days (CPM/Dex/Pred). The primary outcomes were self-reported pruritus VAS scores at 60 min after treatment. We also evaluated 1-week and 1-month urticaria activity scores for 7 days and adverse events. RESULTS: Seventy-five patients (25 per group) were enrolled. The VAS scores of all groups decreased, but no significant difference was found in the VAS scores at 60 min after treatment between patients in the CPM group (n = 25) and those who received both CPM and dexamethasone (n = 50). At the 1-week and 1-month follow-ups, active urticaria (indicated by the urticaria activity score at 7 days) was more prevalent in the CPM/Dex/Pred group (n = 25) than in the control group. CONCLUSIONS: The present study did not find evidence that adding IV dexamethasone improves the treatment of severe pruritus from uncomplicated acute urticaria. Oral corticosteroid therapy may be associated with persistent urticaria activity. Due to the lack of clinical benefits and the potential for side effects, using corticosteroids as an adjunctive treatment is discouraged.

A Comprehensive Approach to Urticaria: From Clinical Presentation to Modern Biological Treatments Through Pathogenesis.

Urticaria is characterized by the cutaneous presence of wheals (hives), angioedema or both. Acute and chronic urticaria are distinguished based on a duration of less or more than 6 weeks. Chronic urticaria can be further classified into a spontaneous form and several inducible types triggered by specific external stimuli. Lifetime prevalence of urticaria may be up to 20%, with the acute form being way more common than the chronic one. Exacerbating factors (e.g. infections, drugs, food) and immune system alterations have been investigated as main triggers of mast cell activation, which in turn leads to increased vascular permeability and extravasation of inflammatory cells. While diagnostic workup is focused upon history taking, several emerging biomarkers correlate with severity and/or prognosis of the disease and can be necessary to differentiate chronic spontaneous urticaria from other disorders, such as vasculitis and autoinflammatory diseases. Treatment of acute urticaria is based upon H1 antihistamines and short courses of steroids. While H1 antihistamines are also used in chronic spontaneous urticaria, omalizumab is the standard of care in patients who are unresponsive to these. Recently, several new drugs have entered clinical trials to offer a therapeutic possibility for patients unresponsive to omalizumab. Numerous target molecules, such as mediators of mast cells activation, are under investigation. Amongst these, new anti-IgE therapies and possibly IL-5 pathway blockade seem to have reached enough data to move to advanced clinical trials.

D-dimer concentrations in acute urticaria in children.

INTRODUCTION: Urticaria is a clinical entity presenting as wheals, angioedema, or both simultaneously. Elevated D-dimer levels were reported in the course of chronic spontaneous urticaria. Data regarding D-dimer levels in acute urticaria in children are limited. OBJECTIVES: To assess potential associations between duration of glucocorticosteroid (GCS) therapy and D-dimer concentrations in children with acute urticaria. PATIENTS, MATERIALS, AND METHODS: Hospital records of 106 children (59 females), aged 5.57 ± 4.91 years, hospitalized in 2014-2018 were analyzed retrospectively. The study group consisted of pediatric patients admitted to the hospital due to severe acute urticaria resistant to antihistaminic treatment that was ordered in the ambulatory care (out-patient clinic). Patients were divided into subgroups: no GCS treatment, short-duration treatment (up to 5 days) and long-duration treatment (6 and more days) GCS treatment. Simultaneously, patients received antihistaminic drugs. D-dimer level and other inflammatory factors such as white blood cell (WBC) count, platelet (PLT) count, and C-reactive protein (CRP) in each group were analyzed. RESULTS: The D-dimer level was elevated in 51% of cases. In the subgroup with longer GCS treatment, D-dimer concentration was significantly higher in comparison to patients with a shorter GCS course. There were no differences in the distribution of CRP, PLT, and WBC concentrations between these subgroups. CONCLUSIONS: In the studied group of children, there was a tendency for higher D-dimer levels in patients, who required a longer GCS treatment. This finding is hypothesis-generating and requires further investigation to confirm if D-dimers can be used as a prognostic factor in acute urticaria in children.

Pediatric urticaria in the Emergency Department: epidemiological characteristics and predictive factors for its persistence in children.

Summary: Introduction. Acute urticaria (AU) in children is a common clinical manifestation responsible for admission to the emergency department (ED). We aimed to analyze the epidemiological characteristics of AU in children and to identify predictors of both severity and progression. Material and methods. We evaluated 314 children admitted to the ED with a diagnosis of AU. We analyzed information concerning its onset, duration, severity, possible triggering factors, and the persistence of symptoms after 1, 3, and 6 months. Results. The most common etiological factors were infections (43.9%); in up to 32.4% of cases, AU was considered as idiopathic. AU was significantly most common in males and pre-school children. At the 6-month follow-up, 9.5% of children presented a persistence of urticaria, mainly those with contact (44.4%) or idiopathic (30.4%) forms. Conclusions. The AU etiology identified by history in the ED may be a significant predictor of persistence after a first attack of AU.

Acute urticaria in the infant.

Urticaria is a mast cell-driven disease presenting with wheals, angioedema, or both. Acute urticaria (AU) lasts < 6 weeks. AU is a not common condition in newborns and infants since they are showing an immune system functionally insufficient. In newborns and infants, AU is typically generalized and featured by large, annular, or geographic plaques, often slightly raised. The clinical features of the disease depend on the peculiar structure of neonatal and infant skin. A careful morphological examination of the lesions is essential to differentiate AU from other skin eruptions that may have overlapping features and to treat it adequately. The second-generation antihistamines are the first-line treatment of AU; however, only antihistamines with proven efficacy and safety should be used in newborns and infants. Corticosteroids may be added in severe cases.

Urticaria: recommendations from the Italian Society of Allergology, Asthma and Clinical Immunology and the Italian Society of Allergological, Occupational and Environmental Dermatology.

BACKGROUND: Urticaria is a disorder affecting skin and mucosal tissues characterized by the occurrence of wheals, angioedema or both, the latter defining the urticaria-angioedema syndrome. It is estimated that 12-22% of the general population has suffered at least one subtype of urticaria during life, but only a small percentage (estimated at 7.6-16%) has acute urticaria, because it is usually self-limited and resolves spontaneously without requiring medical attention. This makes likely that its incidence is underestimated. The epidemiological data currently available on chronic urticaria in many cases are deeply discordant and not univocal, but a recent Italian study, based on the consultation of a national registry, reports a prevalence of chronic spontaneous urticaria of 0.02% to 0.4% and an incidence of 0.1-1.5 cases/1000 inhabitants/year. METHODS: We reviewed the recent international guidelines about urticaria and we described a methodologic approach based on classification, pathophysiology, impact on quality of life, diagnosis and prognosis, differential diagnosis and management of all the types of urticaria. CONCLUSIONS: The aim of the present document from the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC) and the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) is to provide updated information to all physicians involved in diagnosis and management of urticaria and angioedema.

Predictive factors for progression to chronicity or recurrence after the first attack of acute urticaria in preschool-age children.

INTRODUCTION AND OBJECTIVES: Preschool-aged group is frequently affected by urticaria, and infections are the most frequently documented factors that cause acute urticaria in children. This prospective study was designed to investigate the underlying factors of acute urticaria in under five-year-old children and to describe predictive factors for progression to chronicity or recurrence after the first attack. PATIENTS AND METHODS: Children younger than five years of age with acute urticaria were recruited between July 2015 and July 2016. Patients (n=83) were grouped into those below and above two years of age. In order to assess the risk factors for progression to chronicity or recurrence, logistic regression analysis was performed. RESULTS: Upper respiratory tract infection was the most common detectable reason for acute urticaria (49.4%). Herpes Simplex Virus type 1 was significantly isolated in the cases with the manifestation of an acute single-episode urticaria (p=0.042). Angioedema and food allergy were predominantly observed under two years old (p=0.001, p=0.006 respectively). A positive relationship was determined between the duration of urticaria and chronicity (r=0.301, p=0.006). The absence of atopic dermatitis (OR: 6.95, 95% CI: 1.35-35.67, p=0.020), negative Herpes virus serology (OR: 4.25, 95% CI: 0.83-21.56, p=0.040), and unknown etiology (OR: 3.30, 95% CI: 1.12-9.71, p=0.030) were the independent risk factors for recurrent urticaria. CONCLUSIONS: Preschool-aged children with acute urticaria should be evaluated for infections at the time of admission. Patients with unknown etiology, negative Herpes virus serology, absence of atopic dermatitis, and long lasting urticaria should be followed up for chronicity and recurrence.

[What is neutrophilic urticaria?] / Qu'est-ce que l'urticaire neutrophilique ?

Some debate continues to surround the existence of neutrophilic urticaria (NU) as a nosological entity. Certain authors consider NU as a banal form of urticaria since an infiltrate predominantly made up of polynuclear neutrophils (PNN) is seen in certain cases of chronic and acute urticaria. Moreover, it has been stated that the histological appearance of chronic urticaria varies according to the time between appearance of the plaque and the performance of biopsy: the presence of PNN may occur later. According to the literature, there appear to be no specific clinical characteristics associated with the presence of PNN at histology. Most cases exhibit moderate laboratory inflammatory syndrome. Data concerning therapeutic response are contradictory: some studies have shown no significant difference in terms of therapeutic response in relation to banal urticaria, while only one study has demonstrated superior response to dapsone in the case of histologically demonstrated neutrophilic infiltrate. There does not appear to be any disease more frequently associated in the event of NU. In conclusion, the available data concerning NU are insufficient to confirm the existence of this condition. A prospective study comparing routine acute and chronic urticaria biopsies would be extremely useful to better characterise the relationships between cellular infiltrate and therapeutic response.

A Rare Case of Pediatric Bullous Spontaneous Acute Urticaria.

OBJECTIVE: Acute spontaneous bullous urticaria is an extremely rare entity, and there are few reports with blister formation in acute urticaria patients. CLINICAL PRESENTATION AND INTERVENTION: We present a 2-year-old girl who was admitted for bullous spontaneous acute urticaria; the underlying reason for this was not detected. Nikolsky's sign and Darier's sign were negative. Lesions were not compatible with erythema multiforme. However, biopsy was not allowed to be performed. Because of this, the underlying pathogenesis could not be clarified. The patient recovered by a short course of antihistamine and systemic steroid treatment, and the lesions did not recur during a 2-year follow-up. CONCLUSION: Short-term systemic steroid in addition to oral antihistamines resulted in prompt recovery in a patient with acute urticaria complicated by bullae.

Epidemiology of urticaria in Poland - nationally representative survey results.

INTRODUCTION: The prevalence of urticaria is 15-20%. Women are twice as likely to be affected. AIM: To present the epidemiology of urticaria and angioedema in Poland. MATERIAL AND METHODS: A questionnaire-based survey was conducted on a representative group of 4,897 individuals, aged 15-74 years. RESULTS: A total of 11.2% of respondents reported at least one episode of urticaria symptoms in their life, and the frequency was higher in females (OR = 1.46; p < 0.001). Single episodes accounted for 34.8%, while repeated episodes accounted for 65.2%. Acute urticaria was observed in 10.6% (more frequent in females; OR = 1.41; p < 0.001), chronic in 0.6%. Median age of the first episode was 15 years. Angioedema was observed in 3.2%. The last episode of urticaria symptoms and/or angioedema occurred within the previous week in 0.7% of subjects, the last month in 1%, and the last year in 2.2%. 8.8% had experienced urticaria symptoms or angioedema over 1 year prior to the survey. The impact of urticaria symptoms on patients' daily activities was rated with 3.8 points on a scale of 0-10. In addition, chronic urticaria was rated 6.5, and acute urticaria 3.6. Angioedema and urticaria had a negative impact of 5.7 points. CONCLUSIONS: Urticaria and angioedema are serious health problems in Poland, although their prevalence is below the mean rate for the global population. Females are more likely to suffer from these diseases. People affected by urticaria most frequently report contact with plants and substances, insect bites/stings, and food as the provoking factors.

Investigation of thiol-disulphide balance in patients with acute urticaria and chronic spontaneous urticaria.

BACKGROUND: Thiol-disulphide balance plays a major role in health and diseases. This balance may be disrupted by various diseases. We aimed to determine status of the effect of thiol-disulphide balance in urticaria. OBJECTIVES: We aimed to investigate the thiol-disulphide balance in patients with acute urticaria (AUP) and chronic spontaneous urticaria (CSU). METHODS: Study included 53 AUP and 47 healthy controls plus 57 patients with chronic spontaneous urticaria (CSUP) and 57 healthy controls. Levels of native thiols, disulphides and total thiols were evaluated in plasma using a new and automated spectrophotometric method. Ratios of disulphides/total thiols, disulphides/native thiols and native thiols/total thiols were calculated. RESULTS: For AU, there was no statistical difference compared to control group in levels of native thiols, disulphides and total thiols. For CSU, however, there was an increase in levels of native thiols, disulphides and total thiols and the ratio of thiol/disulphide in favour of disulphide. CONCLUSION: Thiol-disulphide balance was not affected by AU but shifted towards to disulphide in CSU indicating the presence of oxidative stress (OS).

Serum vitamin D levels decrease in children with acute urticaria.

BACKGROUND: Acute urticaria is an immune-inflammatory disease, characterised by acute immune activation. There has been increasing evidence showing that vitamin D deficiency is associated with increased incidence and severity of immune-inflammatory disorders. OBJECTIVE: The aim of this study was to evaluate serum vitamin D levels in acute urticaria. METHODS: We enrolled 30 children with acute urticaria and 30 control subjects. Concentrations of 25-hydroxyvitamin D [25(OH)D], a biomarker of vitamin D status, were measured in serum of acute urticaria patients and compared with the control group. RESULTS: There were no significant differences in baseline variables (age, gender, weight) between the groups. Vitamin D deficiency (<20ng/ml) was significantly higher in patients with acute urticaria than in control patients. Serum 25(OH)D levels were significantly lower in the study group compared to those in the control group (13.1±4.3 vs 28.2±7.4ng/mL, p<0.05). Moreover, we found negative correlation between mean duration of acute urticaria and serum vitamin D levels (p<0.01). CONCLUSION: This study revealed a significant association of lower serum 25(OH)D concentrations with acute urticaria and an inverse relationship with disease duration. These findings may open up the possibility of the clinical use of vitamin D as a contributing factor in the pathogenesis of acute urticaria and a predictive marker for disease activity in acute urticaria. A potential role of vitamin D in pathogenesis and additive therapy in acute urticaria needs to be examined.