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A European survey of management approaches in chronic urticaria in children: EAACI Paediatric Urticaria Taskforce
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  • Sophia Tsabouri,
  • Stefania Arasi,
  • Burcin Beken,
  • Martin Church,
  • Montserrat Alvaro,
  • Carlo Caffarelli,
  • Carsten Flohr,
  • Sherief Janmohamed,
  • George Konstantinou,
  • Susanne Lau,
  • Sebastian Lefevre,
  • Charlotte Mørtz,
  • Giovanni Pajno,
  • Helena Pite,
  • Chris Rutkowski,
  • Petra Staubach,
  • Lauri Ann van der Poel,
  • Torsten Zuberbier,
  • Tabie Anika Leslie
Sophia Tsabouri
University of Ioannina Faculty of Medicine
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Stefania Arasi
Ospedale Pediatrico Bambino Gesu
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Burcin Beken
Trakya Universitesi
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Martin Church
Charité, Universitätsmedizin Berlin
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Montserrat Alvaro
Hospital Sant Joan de Deu
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Carlo Caffarelli
Università di Parma
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Carsten Flohr
Guy's and St Thomas' NHS Foundation Trust
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Sherief Janmohamed
Universitair Ziekenhuis Brussel
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George Konstantinou
424 General Military Training Hospital
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Susanne Lau
Charité Campus Virchow
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Sebastian Lefevre
Regional Hospital Centre Metz-Thionville
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Charlotte Mørtz
Odense University Hospital
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Giovanni Pajno
University of Messina
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Helena Pite
Centro Hospitalar Lisboa Central
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Chris Rutkowski
Guy's and St Thomas' NHS Foundation Trust
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Petra Staubach
University Medical Center of Mainz, Johannes Gutenberg-University Mainz
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Lauri Ann van der Poel
Guy's and Saint Thomas' NHS Foundation Trust
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Torsten Zuberbier
Charité - Universitätsmedizin Berlin
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Tabie Anika Leslie
Royal Free Hospital
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Abstract

Background: Although well described in adults, there are scarce and heterogeneous data on the diagnosis and management of chronic urticaria (CU) in children (0-18 years) throughout Europe. Our aim was to explore country differences and identify the extent to which the EAACI/GA²LEN/EDF/WAO guideline recommendations for paediatric urticaria are implemented. Methods: The EAACI Taskforce for paediatric CU disseminated an online clinical survey among EAACI paediatric section members. Members were asked to answer 35 multiple choice questions on current practices in their respective centres. Results: The survey was sent to 2,773 physicians of whom 358 (13.8%) responded, mainly paediatric allergists (80%) and paediatricians (49.7%), working in 69 countries. For diagnosis, Southern European countries used significantly more routine tests (e.g., autoimmune testing, allergological tests, and parasitic investigation) than Northern European countries. Most respondents (60.3%) used a 2nd generation antihistamine as first- line treatment of whom 64.8% up dosed as a second- line. Omalizumab, was used as a second line treatment by 1.7% and third-line by 20.7% of respondents. Most clinicians (65%) follow EAACI/WAO/GA2LEN/EDF guidelines when diagnosing CU, and only 7.3% follow no specific guidelines. Some clinicians prefer to follow national guidelines (18.4%, mainly Northern European) or the AAAAI practice parameter (1.7%). Conclusions: Even though most members of the Paediatric Section of EAACI are familiar with the EAACI/WAO/GA2LEN/EDF guidelines, a significant number do not follow them. Also, the large variation in diagnosis and treatment strengthens the need to re-evaluate, update and standardize guidelines on the diagnosis and management of CU in children.

Peer review status:ACCEPTED

12 Aug 2021Submitted to Pediatric Allergy and Immunology
13 Aug 2021Reviewer(s) Assigned
13 Aug 2021Review(s) Completed, Editorial Evaluation Pending
16 Aug 2021Editorial Decision: Revise Minor
19 Sep 20211st Revision Received
21 Sep 2021Review(s) Completed, Editorial Evaluation Pending
27 Sep 2021Editorial Decision: Accept