Chinese Journal of Dermatology ›› 2024, Vol. 57 ›› Issue (6): 510-515.doi: 10.35541/cjd.20230544

• Original Articles • Previous Articles     Next Articles

Clinical features of 131 patients with chronic spontaneous urticaria accompanied by angioedema or not: a retrospective study

Wang Linxia, Zhang Liming, Shi Meihui, Gao Xinghua, Chen Hongduo, Xiao Ting   

  1. Department of Dermatology, the First Hospital of China Medical University, National Health Commission Key Laboratory of Immunodermatology, Key Laboratory of Immunodermatology of Ministry of Education, National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang 110001, China
  • Received:2023-09-20 Revised:2024-03-20 Online:2024-06-15 Published:2024-06-03
  • Contact: Xiao Ting; Chen Hongduo E-mail:cmuxt@126.com; hongduochen@hotmail.com
  • Supported by:
    National Key Clinical Specialist Subject Construction Project(Health Office Medical Administration Letter [2012]649)

Abstract: 【Abstract】 Objective To investigate the clinical features of chronic spontaneous urticaria (CSU) patients with angioedema (AE). Methods Clinical data were collected from adult outpatients with active CSU diagnosed and treated at the First Hospital of China Medical University from January 2019 to December 2021, and analyzed retrospectively. The data included gender, age, disease duration, the presence or absence of angioedema, urticaria activity score for one day, prior treatments, previous history, family history, laboratory test results, therapeutic effect, and adverse reactions. Their treatment regimens were based on the Chinese guidelines for the diagnosis and treatment of urticaria (2018) and the American guidelines for the diagnosis and management of urticaria (2014). Statistical analysis was carried out by using Mann-Whitney U test, two-independent-sample t test, Chi-square test, corrected Chi-square test, and Fisher's exact test. Results A total of 131 CSU patients were collected, including 78 females and 53 males. Their age at the first visit was 44.6 ± 13.3 years, and the disease duration (M[Q1, Q3]) was 4.0 (2.0, 10.0) months. Among these CSU patients, there were 58 with AE and 73 without AE. The disease duration was significantly longer in the CSU patients with AE (6.0 [3.0, 24.0] months) than in those without AE (3.5 [2.0, 6.0] months; Z = -2.78, P = 0.005). The urticaria activity score for one day was also significantly higher in the CSU patients with AE (5.0 [3.0, 5.3] points) than in those without AE (4.0 [3.0, 5.0] points; Z = -2.63, P = 0.008). The CSU patients with AE showed a decreased proportion of patients completely controlled by licensed-dose second-generation H1-antihistamines (sgAHs) (8.6%, 5/58) compared with those without AE (24.7%, 18/73), but an increased proportion of patients uncontrolled by licensed-dose sgAHs (91.4%, 53/58) compared with those without AE (74.0%, 54/73; Z = -2.53, P = 0.011); there were no significant differences in the proportions of patients completely controlled or uncontrolled by updosed sgAHs alone or combinations of 2- to 4-fold equivalent-dose sgAHs, or in the proportions of patients completely controlled or uncontrolled by combination therapy with 4-fold equivalent-dose sgAHs and non-H1-antihistamines between the CSU patients with AE and those without AE (P > 0.05). Conclusion Compared with the CSU patients without AE, the CSU patients with AE had a longer disease duration, higher disease activity, a lower proportion of patients completely controlled by licensed-dose sgAHs, and a higher proportion of patients uncontrolled by licensed-dose sgAHs.

Key words: Urticaria, Angioedema, Chronic spontaneous urticaria, Clinical features, Treatment outcome