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The common triggers of urticaria in children admitted to the pediatric emergency room
Background Urticaria frequently causes pediatric emergency department (PED) admissions. Children with urticaria may unnecessarily avoid suspected allergens. We aimed to investigate the possible and exact triggers of urticaria in children admitted to the PED. Methods Medical records of children admit...
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| Published in: | Pediatric dermatology 2022-09, Vol.39 (5), p.695-701 |
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| container_end_page | 701 |
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| container_title | Pediatric dermatology |
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| creator | Bezirganoglu, Handan Arik Yilmaz, Ebru Sahiner, Umit M. Soyer, Ozge Sekerel, Bulent E. Teksam, Ozlem Buyuktiryaki, Betul Sackesen, Cansin |
| description | Background
Urticaria frequently causes pediatric emergency department (PED) admissions. Children with urticaria may unnecessarily avoid suspected allergens. We aimed to investigate the possible and exact triggers of urticaria in children admitted to the PED.
Methods
Medical records of children admitted to the PED within a 1‐year period were evaluated for the International Classification of Diseases 10 (ICD‐10) L50 urticaria code, noting symptoms, and possible triggers of urticaria. We performed telephone interviews to complete the missing data and further diagnostic tests for IgE‐mediated allergies to identify the exact triggers of urticaria.
Results
Among 60,142 children, 462 (0.8%) with the L50 code were evaluated. Possible triggers based on the history and physical examination could be identified in 46%: infections (18%), drugs (11%), foods (8%), infections and drugs (3%), insects (3%), pollen (1%), blood products (0.4%), and vaccines (0.4%). The most frequent infections related to urticaria were upper respiratory tract infections (74.5%), urinary tract infections (13.2%), gastroenteritis (8.2%), and otitis media (4.1%). After a diagnostic workup, IgE‐mediated allergic diseases were diagnosed in 6% of patients. Twenty‐two percent of the patients had multiple PED admission for the same urticaria flare. Urticaria severity was found to be the most important risk factor for readmissions to the PED (odds ratio: 3.86; 95% confidence interval: 2.39–6.23; p |
| doi_str_mv | 10.1111/pde.15020 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2661078156</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2661078156</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2830-16d986ba8b14649b4a6cecf4d3b7f99bc9a4f97e6ff6c5a724c010cb0f0062653</originalsourceid><addsrcrecordid>eNp1kE9LxDAQxYMouq4e_AIS8KKH6iRN0_Yo_gdBD3oOaTpZI22zJi2y397oqgfBOcxcfu_x5hFywOCUpTlbtnjKCuCwQWas4EXGRAmbZAZlLrMKhNwhuzG-AkAlJdsmO3lRcM6EnJHnpxekxve9H-gY3GKBIVJv6RRGZ3RwmrqBmhfXtQEHqtvejSO2dPR0TMIltk4nmaHYY1jgYFY0eN_vkS2ru4j733dOnq-vni5us_uHm7uL8_vM8CqHjMm2rmSjqyZlEXUjtDRorGjzprR13ZhaC1uXKK2VptAlFwYYmAYsgOSyyOfkeO27DP5twjiq3kWDXacH9FNUPL0LZcUKmdCjP-irn8KQ0ilecp5Lkac9JydrygQfY0CrlsH1OqwUA_XZtUpdq6-uE3v47Tg1Pba_5E-5CThbA--uw9X_Turx8mpt-QHpjYeR</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2722364322</pqid></control><display><type>article</type><title>The common triggers of urticaria in children admitted to the pediatric emergency room</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Bezirganoglu, Handan ; Arik Yilmaz, Ebru ; Sahiner, Umit M. ; Soyer, Ozge ; Sekerel, Bulent E. ; Teksam, Ozlem ; Buyuktiryaki, Betul ; Sackesen, Cansin</creator><creatorcontrib>Bezirganoglu, Handan ; Arik Yilmaz, Ebru ; Sahiner, Umit M. ; Soyer, Ozge ; Sekerel, Bulent E. ; Teksam, Ozlem ; Buyuktiryaki, Betul ; Sackesen, Cansin</creatorcontrib><description>Background
Urticaria frequently causes pediatric emergency department (PED) admissions. Children with urticaria may unnecessarily avoid suspected allergens. We aimed to investigate the possible and exact triggers of urticaria in children admitted to the PED.
Methods
Medical records of children admitted to the PED within a 1‐year period were evaluated for the International Classification of Diseases 10 (ICD‐10) L50 urticaria code, noting symptoms, and possible triggers of urticaria. We performed telephone interviews to complete the missing data and further diagnostic tests for IgE‐mediated allergies to identify the exact triggers of urticaria.
Results
Among 60,142 children, 462 (0.8%) with the L50 code were evaluated. Possible triggers based on the history and physical examination could be identified in 46%: infections (18%), drugs (11%), foods (8%), infections and drugs (3%), insects (3%), pollen (1%), blood products (0.4%), and vaccines (0.4%). The most frequent infections related to urticaria were upper respiratory tract infections (74.5%), urinary tract infections (13.2%), gastroenteritis (8.2%), and otitis media (4.1%). After a diagnostic workup, IgE‐mediated allergic diseases were diagnosed in 6% of patients. Twenty‐two percent of the patients had multiple PED admission for the same urticaria flare. Urticaria severity was found to be the most important risk factor for readmissions to the PED (odds ratio: 3.86; 95% confidence interval: 2.39–6.23; p < .001). No relationship between urticaria severity, duration, and the triggers was present.
Conclusions
Despite detailed diagnostic tests, IgE‐mediated allergic triggers were rarely the cause of urticaria in children admitted to the PED. Infections are the most frequent trigger. Severe urticaria causes more frequent readmissions to the PED.</description><identifier>ISSN: 0736-8046</identifier><identifier>EISSN: 1525-1470</identifier><identifier>DOI: 10.1111/pde.15020</identifier><identifier>PMID: 35522146</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Allergens ; Allergic diseases ; Angioedema ; Children ; Dermatology ; Diagnostic tests ; drug allergy ; Edema ; Emergency medical care ; Food allergies ; food allergy ; Gastroenteritis ; Immunoglobulin E ; Infections ; Medical records ; Otitis media ; Patients ; pediatric emergency department ; Pediatrics ; Respiratory tract diseases ; Risk factors ; Urinary tract ; Urticaria ; urticaria activity score ; urticaria severity</subject><ispartof>Pediatric dermatology, 2022-09, Vol.39 (5), p.695-701</ispartof><rights>2022 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2830-16d986ba8b14649b4a6cecf4d3b7f99bc9a4f97e6ff6c5a724c010cb0f0062653</citedby><cites>FETCH-LOGICAL-c2830-16d986ba8b14649b4a6cecf4d3b7f99bc9a4f97e6ff6c5a724c010cb0f0062653</cites><orcidid>0000-0003-1206-969X ; 0000-0003-4232-3396 ; 0000-0002-1115-9805 ; 0000-0003-0088-913X ; 0000-0003-1856-0500 ; 0000-0002-5720-7104 ; 0000-0002-7444-251X ; 0000-0002-6204-2754</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35522146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bezirganoglu, Handan</creatorcontrib><creatorcontrib>Arik Yilmaz, Ebru</creatorcontrib><creatorcontrib>Sahiner, Umit M.</creatorcontrib><creatorcontrib>Soyer, Ozge</creatorcontrib><creatorcontrib>Sekerel, Bulent E.</creatorcontrib><creatorcontrib>Teksam, Ozlem</creatorcontrib><creatorcontrib>Buyuktiryaki, Betul</creatorcontrib><creatorcontrib>Sackesen, Cansin</creatorcontrib><title>The common triggers of urticaria in children admitted to the pediatric emergency room</title><title>Pediatric dermatology</title><addtitle>Pediatr Dermatol</addtitle><description>Background
Urticaria frequently causes pediatric emergency department (PED) admissions. Children with urticaria may unnecessarily avoid suspected allergens. We aimed to investigate the possible and exact triggers of urticaria in children admitted to the PED.
Methods
Medical records of children admitted to the PED within a 1‐year period were evaluated for the International Classification of Diseases 10 (ICD‐10) L50 urticaria code, noting symptoms, and possible triggers of urticaria. We performed telephone interviews to complete the missing data and further diagnostic tests for IgE‐mediated allergies to identify the exact triggers of urticaria.
Results
Among 60,142 children, 462 (0.8%) with the L50 code were evaluated. Possible triggers based on the history and physical examination could be identified in 46%: infections (18%), drugs (11%), foods (8%), infections and drugs (3%), insects (3%), pollen (1%), blood products (0.4%), and vaccines (0.4%). The most frequent infections related to urticaria were upper respiratory tract infections (74.5%), urinary tract infections (13.2%), gastroenteritis (8.2%), and otitis media (4.1%). After a diagnostic workup, IgE‐mediated allergic diseases were diagnosed in 6% of patients. Twenty‐two percent of the patients had multiple PED admission for the same urticaria flare. Urticaria severity was found to be the most important risk factor for readmissions to the PED (odds ratio: 3.86; 95% confidence interval: 2.39–6.23; p < .001). No relationship between urticaria severity, duration, and the triggers was present.
Conclusions
Despite detailed diagnostic tests, IgE‐mediated allergic triggers were rarely the cause of urticaria in children admitted to the PED. Infections are the most frequent trigger. Severe urticaria causes more frequent readmissions to the PED.</description><subject>Allergens</subject><subject>Allergic diseases</subject><subject>Angioedema</subject><subject>Children</subject><subject>Dermatology</subject><subject>Diagnostic tests</subject><subject>drug allergy</subject><subject>Edema</subject><subject>Emergency medical care</subject><subject>Food allergies</subject><subject>food allergy</subject><subject>Gastroenteritis</subject><subject>Immunoglobulin E</subject><subject>Infections</subject><subject>Medical records</subject><subject>Otitis media</subject><subject>Patients</subject><subject>pediatric emergency department</subject><subject>Pediatrics</subject><subject>Respiratory tract diseases</subject><subject>Risk factors</subject><subject>Urinary tract</subject><subject>Urticaria</subject><subject>urticaria activity score</subject><subject>urticaria severity</subject><issn>0736-8046</issn><issn>1525-1470</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kE9LxDAQxYMouq4e_AIS8KKH6iRN0_Yo_gdBD3oOaTpZI22zJi2y397oqgfBOcxcfu_x5hFywOCUpTlbtnjKCuCwQWas4EXGRAmbZAZlLrMKhNwhuzG-AkAlJdsmO3lRcM6EnJHnpxekxve9H-gY3GKBIVJv6RRGZ3RwmrqBmhfXtQEHqtvejSO2dPR0TMIltk4nmaHYY1jgYFY0eN_vkS2ru4j733dOnq-vni5us_uHm7uL8_vM8CqHjMm2rmSjqyZlEXUjtDRorGjzprR13ZhaC1uXKK2VptAlFwYYmAYsgOSyyOfkeO27DP5twjiq3kWDXacH9FNUPL0LZcUKmdCjP-irn8KQ0ilecp5Lkac9JydrygQfY0CrlsH1OqwUA_XZtUpdq6-uE3v47Tg1Pba_5E-5CThbA--uw9X_Turx8mpt-QHpjYeR</recordid><startdate>202209</startdate><enddate>202209</enddate><creator>Bezirganoglu, Handan</creator><creator>Arik Yilmaz, Ebru</creator><creator>Sahiner, Umit M.</creator><creator>Soyer, Ozge</creator><creator>Sekerel, Bulent E.</creator><creator>Teksam, Ozlem</creator><creator>Buyuktiryaki, Betul</creator><creator>Sackesen, Cansin</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1206-969X</orcidid><orcidid>https://orcid.org/0000-0003-4232-3396</orcidid><orcidid>https://orcid.org/0000-0002-1115-9805</orcidid><orcidid>https://orcid.org/0000-0003-0088-913X</orcidid><orcidid>https://orcid.org/0000-0003-1856-0500</orcidid><orcidid>https://orcid.org/0000-0002-5720-7104</orcidid><orcidid>https://orcid.org/0000-0002-7444-251X</orcidid><orcidid>https://orcid.org/0000-0002-6204-2754</orcidid></search><sort><creationdate>202209</creationdate><title>The common triggers of urticaria in children admitted to the pediatric emergency room</title><author>Bezirganoglu, Handan ; Arik Yilmaz, Ebru ; Sahiner, Umit M. ; Soyer, Ozge ; Sekerel, Bulent E. ; Teksam, Ozlem ; Buyuktiryaki, Betul ; Sackesen, Cansin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2830-16d986ba8b14649b4a6cecf4d3b7f99bc9a4f97e6ff6c5a724c010cb0f0062653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Allergens</topic><topic>Allergic diseases</topic><topic>Angioedema</topic><topic>Children</topic><topic>Dermatology</topic><topic>Diagnostic tests</topic><topic>drug allergy</topic><topic>Edema</topic><topic>Emergency medical care</topic><topic>Food allergies</topic><topic>food allergy</topic><topic>Gastroenteritis</topic><topic>Immunoglobulin E</topic><topic>Infections</topic><topic>Medical records</topic><topic>Otitis media</topic><topic>Patients</topic><topic>pediatric emergency department</topic><topic>Pediatrics</topic><topic>Respiratory tract diseases</topic><topic>Risk factors</topic><topic>Urinary tract</topic><topic>Urticaria</topic><topic>urticaria activity score</topic><topic>urticaria severity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bezirganoglu, Handan</creatorcontrib><creatorcontrib>Arik Yilmaz, Ebru</creatorcontrib><creatorcontrib>Sahiner, Umit M.</creatorcontrib><creatorcontrib>Soyer, Ozge</creatorcontrib><creatorcontrib>Sekerel, Bulent E.</creatorcontrib><creatorcontrib>Teksam, Ozlem</creatorcontrib><creatorcontrib>Buyuktiryaki, Betul</creatorcontrib><creatorcontrib>Sackesen, Cansin</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bezirganoglu, Handan</au><au>Arik Yilmaz, Ebru</au><au>Sahiner, Umit M.</au><au>Soyer, Ozge</au><au>Sekerel, Bulent E.</au><au>Teksam, Ozlem</au><au>Buyuktiryaki, Betul</au><au>Sackesen, Cansin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The common triggers of urticaria in children admitted to the pediatric emergency room</atitle><jtitle>Pediatric dermatology</jtitle><addtitle>Pediatr Dermatol</addtitle><date>2022-09</date><risdate>2022</risdate><volume>39</volume><issue>5</issue><spage>695</spage><epage>701</epage><pages>695-701</pages><issn>0736-8046</issn><eissn>1525-1470</eissn><abstract>Background
Urticaria frequently causes pediatric emergency department (PED) admissions. Children with urticaria may unnecessarily avoid suspected allergens. We aimed to investigate the possible and exact triggers of urticaria in children admitted to the PED.
Methods
Medical records of children admitted to the PED within a 1‐year period were evaluated for the International Classification of Diseases 10 (ICD‐10) L50 urticaria code, noting symptoms, and possible triggers of urticaria. We performed telephone interviews to complete the missing data and further diagnostic tests for IgE‐mediated allergies to identify the exact triggers of urticaria.
Results
Among 60,142 children, 462 (0.8%) with the L50 code were evaluated. Possible triggers based on the history and physical examination could be identified in 46%: infections (18%), drugs (11%), foods (8%), infections and drugs (3%), insects (3%), pollen (1%), blood products (0.4%), and vaccines (0.4%). The most frequent infections related to urticaria were upper respiratory tract infections (74.5%), urinary tract infections (13.2%), gastroenteritis (8.2%), and otitis media (4.1%). After a diagnostic workup, IgE‐mediated allergic diseases were diagnosed in 6% of patients. Twenty‐two percent of the patients had multiple PED admission for the same urticaria flare. Urticaria severity was found to be the most important risk factor for readmissions to the PED (odds ratio: 3.86; 95% confidence interval: 2.39–6.23; p < .001). No relationship between urticaria severity, duration, and the triggers was present.
Conclusions
Despite detailed diagnostic tests, IgE‐mediated allergic triggers were rarely the cause of urticaria in children admitted to the PED. Infections are the most frequent trigger. Severe urticaria causes more frequent readmissions to the PED.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35522146</pmid><doi>10.1111/pde.15020</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-1206-969X</orcidid><orcidid>https://orcid.org/0000-0003-4232-3396</orcidid><orcidid>https://orcid.org/0000-0002-1115-9805</orcidid><orcidid>https://orcid.org/0000-0003-0088-913X</orcidid><orcidid>https://orcid.org/0000-0003-1856-0500</orcidid><orcidid>https://orcid.org/0000-0002-5720-7104</orcidid><orcidid>https://orcid.org/0000-0002-7444-251X</orcidid><orcidid>https://orcid.org/0000-0002-6204-2754</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Pediatric dermatology, 2022-09, Vol.39 (5), p.695-701 |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Allergens Allergic diseases Angioedema Children Dermatology Diagnostic tests drug allergy Edema Emergency medical care Food allergies food allergy Gastroenteritis Immunoglobulin E Infections Medical records Otitis media Patients pediatric emergency department Pediatrics Respiratory tract diseases Risk factors Urinary tract Urticaria urticaria activity score urticaria severity |
| title | The common triggers of urticaria in children admitted to the pediatric emergency room |
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