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

Abstract

<b>Background.</b> Acute urticaria is a common condition in the pediatric emergency department (ED) and no data is available in Portugal. <b>Objective.</b> 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.<b>Methods.</b> Retrospective study of clinical records from children admitted to the ED with acute urticaria during one year period. <b>Results.</b> 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 β-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). <b>Conclusions.</b> 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.