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Lee, Lee, Han, and Yoon: Allergen sensitization and vitamin D status in young Korean children with urticaria
Original Article

Allergy Asthma Respir Dis 2017;5(3):153-158.

Published online: 5 May 2017

DOI: https://doi.org/10.4168/aard.2017.5.3.153

Allergen sensitization and vitamin D status in young Korean children with urticaria

Jeong Bong Lee1, Shin Hae Lee2, Man Yong Han2, Jung Won Yoon1

1Department of Pediatrics, Seonam University of Medicine, Myongji Hospital, Goyang, Korea

2Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seoul, Korea

Correspondence to: Jung Won Yoon https://orcid.org/0000-0001-7518-2062 Department of Pediatrics, Seonam University School of Medicine, Myongji Hospital, 55 Hwasu-ro 14beon-gil, Deokyang-gu, Goyang 10475, Korea Tel: +82-31-810-7020, Fax: +82-31-969-0500, E-mail: woorigon@gmail.com

Received 11 September 201620 October 2016       Accepted 14 November 2016

Copyright © 2017 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Urticaria is a common disorder, with a lifetime incidence of approximately 15%–20% of the general population. It is difficult to differentiate urticaria in children because of the similarity in symptoms between acute and chronic urticaria. There is also a lack of studies between vitamin D known as an important role in the immune system and urticaria in children. The present study aimed to assess the characteristics and allergen sensitization of young children diagnosed with urticaria and to evaluate the relationship between their vitamin D status and urticaria.

Methods

We retrospectively reviewed medical records of 218 children diagnosed as having urticaria at CHA and Myongji Hospitals between April 2013 and December 2014. The results of questionnaires and laboratory tests, including specific IgE and serum 25-hy-droxy vitamin D concentrations were obtained.

Results

Of 218 patients, 118 (54%) were positive for at least 1 allergen and there was no significant difference in the prevalence of sensitization between the acute and chronic urticaria groups. However, the prevalence of polysensitization and sensitization of house dust mites was significantly higher in the chronic urticaria group than in the acute urticaria group (P=0.011 and P=0.029, respectively). Among the urticaria symptoms, an itching sensation was more associated with insufficient vitamin D status in children with urticaria (P=0.034).

Conclusion

Our results demonstrated that children with chronic urticaria have a higher prevalence of sensitization to house dust mites and polysensitization. Further studies will need to determine whether the supply of vitamin D can improve itching sensation in urticaria children with an insufficient vitamin D status.

Keywords: Urticaria, Child, Sensitization, Vitamin D

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Fig. 1.
Comparison of polysensitization and house dust mite antigen sensitization in patients with acute and chronic urticaria. The prevalence of polysensitization and sensitization of house dust mites is significantly higher in the chronic urticaria group than in the acute urticaria group (P=0.011 and P=0.029).
aard-5-153f1.tif
Fig. 2.
Distribution of aeroallergen and food allergen sensitization in urticaria children by age. Aeroallergen sensitization rates, including house dust mite and pollen show a tendency to increase with age. However, the rate of food allergen sensitization tends to decrease with age.
aard-5-153f2.tif
Table 1.
Demographic characteristics of the study populations
Characteristic Acute urticaria (n=173) Chronic urticaria (n=45) P-value
Age (yr) 3.4±3.2 4.2±3.6 0.165
Male sex 85 (49.1) 26 (57.8) 0.301
Severity      
 Area 1.2±0.8 (0–3) 0.9±0.8 (0–3) 0.119
 Itching 1.9±1.1 (0–3) 1.8±1.2 (0–3) 0.832
Allergic disease of patients      
 Allergic rhinitits 41 (23.7) 11 (24.4) 0.948
 Atopic dermatitis 27 (15.6) 12 (26.7) 0.091
 Asthma 5 (2.9) 1 (2.2) 0.799
Allergic disease of family      
 Allergic rhinitits 80 (46.2) 17 (37.8) 0.309
 Atopic dermatitis 20 (11.6) 5 (11.1) 0.933
 Asthma 6 (3.4) 1 (2.2) 0.673

Values are presented as mean±standard deviation (SD), number (%), or mean±SD (range).

Table 2.
Comparison of serologic tests and allergen sensitization betwee acute and chronic urticarial
Variable Acute urticaria (n=173) Chronic urticaria (n=45) P-value
Log (total IgE) 1.6±0.5 1.8 ±0.7 0.240
Eosinophil count (%) 3.1±2.5 3.3 ±1.9 0.691
Vitamin D (ng/mL) 22.6±7.4 22.4±7.3 0.865
 Insufficient, <30 126 (83.4) 36 (83.7) 0.966
C3 (mg/dL) 121.1±25.2 118.0±22.3 0.534
C4 (mg/dL) 24.7±8.6 25.1±9.4 0.821
Positive sensitization 92 (59.7) 26 (60.5) 0.932
Polysensitization 57 (37.0) 23 (53.5) 0.011

Values are presented as mean±standard deviation or number (%).

Table 3.
Prevalence of positive serum specific IgE tests in acute and chronic urticarial
Allergen Acute urticaria Chronic urticaria P-value
Aeroallergens 54/147 (36.7) 22/43 (51.2) 0.085
 House dust mite 51/147 (34.7) 21/39 (53.8) 0.029
 Animal dander 10/141 (7.1) 7/41 (17.1) 0.053
 Pollen 11/142 (7.7) 2/41 (4.9) 0.529
Food allergens 51/154 (33.1) 16/43 (37.2) 0.616
 Egg 20/145 (13.8) 7/42 (16.7) 0.641
 Milk 24/142 (16.9) 7/41 (17.1) 0.979
 Peanut 9/138 (6.5) 4/40 (10) 0.430

Values are presented as number (%).

Table 4.
Comparisons of clinical characteristics and allergen sensitization b serum 25-hydroxy vitamin D (25(OH)D) level in urticaria patients
Variable 25(OH)D
 P-value
≥30 ng/mL (n=32) <30 ng/mL (n=161)
Severity      
 Area 1.2±0.78 1.1±0.86 0.383
 Itching 1.46±1.17 1.93±1.06 0.034
Allergic disease of patients      
 Allergic rhinitits 3 (9.4) 44 (27.3) 0.031
 Atopic dermatitis 2 (6.2) 33 (20.5) 0.056
 Asthma 0 (0) 5 (3.1) 0.312
Positive sensitization 66 (69.5) 11 (55) 0.211

Values are presented as mean±standard deviation or number (%).

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