Chronic urticaria in childhood: how to treat?
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Abstract
Introduction: Chronic urticaria can affect all ages and the prevalence is low in childhood. Introduction: Chronic urticaria can affect all ages with a low prevalence in childhood. Correct treatment is important to avoid unnecessary adverse effects. Objective: To report a case of a child with chronic spontaneous urticaria (ECU) with adverse effects due to inadequate treatment. Case description: A boy, 8 years old, presented ECU lasting more than 6 weeks. He sought emergency medical care several times, and first generation antihistamines (anti H1) were prescribed in association with oral corticosteroids that were maintained for 4 months, evolving with side effects due to corticosteroid therapy. He was evaluated by an allergist and complementary exams showed adrenal suppression. He started treatment with second generation anti-H1 in a dose four times above the licensed dose, gradually reducing the corticosteroid and after 2 years, the patient has control of symptoms using standardized desloratadine. Comments: The use of second generation anti-H1 is the first choice in the treatment of chronic urticaria. In case of failure, the dose may even be quadrupled. If control does not occur, the third step is the addition of omalizumab for children over 12 years old. The fourth step is the inclusion of cyclosporine. The use of corticosteroids is restricted to short courses in exacerbations.
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