Abstract:

Although the etiology of chronic spontaneous urticaria (CSU) in children is mostly idiopathic, there are studies supporting the autoimmune pathogenesis of disease in a subset of patients. CSU and autoimmune thyroid disease coexistence has been explored mostly in adults; however data in children is scarce. The aim of this study was to verify frequency of anti thyroid peroxidase (anti-TPO) antibody positivity and risk factors for autoimmune thyroid disorder in the children with CSU. In this retrospective descriptive study, a total of 126 children with CSU in two different centers were evaluated. The demographic and clinical features, coexisting connective tissue diseases, autoimmune and/or allergic diseases and complete blood count, total IgE,  antinuclear antibody (ANA), anti-TPO antibody, free thyroxine (fT4), thyroid-stimulating hormone (TSH), skin prick test and autologous serum skin test (ASST) results that routinely performed for CSU in both centers were collected from medical records. Thyroid ultrasonography findings were also recorded in the patients with positive anti-TPO. Anti-TPO was positivite in 5 (4.0%)  patients. Heterogenous paranchyme on thyroid US was detected in 3 of those. ANA was positive 10.1% of the patients. In anti-TPO positive patients, ANA positivity was significantly higher (60% vs 7.4%, respectively; p=0.003). Vitiligo was detected in 4 (3.2%) of patients and although it is not significant statistically, these patients had higher frequency of anti-TPO positivity compare to those without vitiligo (20% vs 2.5%, respectively; p=0.151). ANA positivity may be a risk factor for autoimmune thyroid disorder in patients with chronic spontaneous urticaria. Relationship between vitiligo and autoimmun thyroid disorder should also be investigated in patients with CSU in larger cohorts

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