Pediatrics & Neonatology
Volume 49, Issue 3 , Pages 58-64, June 2008

First Attack of Acute Urticaria in Pediatric Emergency Department

  • Tzu-Hsuan Liu

      Affiliations

    • Department of Dermatology, Changhua Christian Hospital, Changhua, Taiwan
    • ,
  • Yan-Ren Lin

      Affiliations

    • Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan
    • ,
  • Kuo-Chia Yang

      Affiliations

    • Department of Dermatology, Changhua Christian Hospital, Changhua, Taiwan
    • ,
  • Chu-Chung Chou

      Affiliations

    • Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan
    • Institute of Medicine, Chungshan Medical University, Taichung, Taiwan
    • ,
  • Yu-Jun Chang

      Affiliations

    • Laboratory of Epidemiology and Biostatistics, Changhua Christian Hospital, Changhua, Taiwan
    • ,
  • Han-Ping Wu

      Affiliations

    • Department of Pediatrics, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Pediatrics, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, No. 66, Section 1, Fongsing Road, Tanzih Township, Taichung County 42743, Taiwan

Received 1 August 2007; received in revised form 3 January 2008; accepted 25 June 2008.

Article Outline

Background

Management of a first attack of acute urticaria in children is dependent on the etiology of the disease. Knowledge of the various etiologies of urticaria will help primary physicians to perform appropriate clinical assessments. In this study, we analyzed the etiologies and their prevalence in first-attack acute urticaria in infants, children and adolescents in central Taiwan.

Methods

This was a retrospective study of 953 children who were admitted to the emergency department (ED) with a first attack of acute urticaria from January 2000 to December 2006. All patients were followed in the ED or outpatient department until their symptoms subsided. Patient demographics and detailed etiologies of the first attack of acute urticaria were analyzed. Furthermore, the prevalence of various etiologies in different age groups, as well as the etiologic trends of acute urticaria in children during the previous 7 years, was determined.

Results

The most common etiologies of a first attack of acute urticaria in children were various infections (48.4%), foods (23.5%), idiopathic causes (13.2%), and medications (11.5%). Among the three major etiologies above, upper respiratory tract infections (nasopharyngitis), seafood (shrimp) and nonsteroidal anti-inflammatory drugs (ibuprofen) were the most frequent causes. Moreover, the etiologies differed significantly with patient age (p < 0.001). Overall, infections were the major cause in infants (56.5%), whereas food (36.6%) and medications (26.8%) were the most common etiologies in adolescents. The prevalence of various infections dropped as the age of the children increased (56.5% in infants, 51.2% in preschool-aged children, 42.1% in school-aged children and 17.1% in adolescents). The etiologies of foods and medications were more prevalent in adolescents than in younger children.

Conclusion

Detailed etiologies of first-attack urticaria in children in central Taiwan were analyzed. Most importantly, we found that there was a decrease in the prevalence of various infections as causative factors as the age of the children increased. The etiologies of foods and medications were more prevalent in adolescents than in younger children.

Key Words:  acute urticaria , children

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PII: S1875-9572(08)60014-5

doi:10.1016/S1875-9572(08)60014-5

Pediatrics & Neonatology
Volume 49, Issue 3 , Pages 58-64, June 2008

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