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

Background. Acute urticaria is a common condition in the pediatric Emergency Department (ED) and no data is available in Portugal. Objective. 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. Methods. Retrospective study of clinical records from children admitted to the ED with acute urticaria during one year period. Results. 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 beta-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). Conclusions. 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.