荨麻疹血管炎与慢性自发性荨麻疹的鉴别诊断:国际德尔菲调查

IF 4.6 2区 医学 Q2 ALLERGY Clinical and Translational Allergy Pub Date : 2023-10-19 DOI:10.1002/clt2.12305
Karoline Krause, Hanna Bonnekoh, Jannis Jelden-Thurm, Riccardo Asero, Ana Maria Gimenez-Arnau, José C. Cardoso, Clive Grattan, Emek Kocatürk, Undine Lippert, Marcus Maurer, Martin Metz, Petra Staubach, Margarida Goncalo, Pavel Kolkhir
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引用次数: 0

摘要

背景在最初表现为复发性风团的患者中,应将荨麻疹血管炎(UV)与慢性自发性荨麻疹(CSU)区分开来,尽管鉴别诊断的标准仍不明确。目的确定紫外线诊断和CSU鉴别诊断的目标、标准和未满足的需求,探讨两种疾病共存的可能性。方法13名具有紫外线研究经验的专家参加了欧洲过敏与临床免疫学研究所的德尔菲调查。这项德尔菲调查涉及对n=32个问题的三轮匿名回答,目的是汇集专家的意见并达成共识。荨麻疹专家(n=130,大多数来自荨麻疹参考和卓越中心)在第四轮也是最后一轮中评估了共识声明和建议。结果专家组一致认为,指导复发性风团患者进行皮肤活检的基本标准应至少包括以下特征之一:风团持续时间>;24小时,瘀伤/炎症后色素沉着和全身症状。白细胞不全和纤维蛋白沉积被确定为紫外线组织学的最低标准。正如小组成员所同意的那样,CSU和正常补充性紫外线(NUV)可能在一些患者中共存。结论应用已建立的诊断和鉴别诊断复发性风团患者紫外线的标准有助于指导诊断方法,促进早期治疗。进一步的研究应该调查CSU和NUV是不同的实体还是疾病谱的一部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Differential diagnosis between urticarial vasculitis and chronic spontaneous urticaria: An international Delphi survey

Background

Urticarial vasculitis (UV) should be differentiated from chronic spontaneous urticaria (CSU) in patients initially presenting with recurrent wheals, although criteria for differential diagnosis remain ill-defined.

Objectives

To set the goals, define criteria and unmet needs in UV diagnosis and differential diagnosis with CSU, and explore the possibility of coexistence of both diseases.

Methods

Thirteen experts experienced in UV research participated in a Delphi survey of European Academy of Allergy and Clinical Immunology taskforce. This Delphi survey involved three rounds of anonymous responses to n = 32 questions with the aim to aggregate the experts' opinions and to achieve consensus. Urticaria specialists (n = 130, most from Urticaria Centers of Reference and Excellence) evaluated the consensus statements and recommendations in the fourth and final round.

Results

The panel agreed that essential criteria to guide a skin biopsy in patients with recurrent wheals should include at least one of the following features: wheal duration >24 h, bruising/postinflammatory hyperpigmentation, and systemic symptoms. Leukocytoclasia and fibrin deposits were identified as a minimum set of UV histological criteria. As agreed by the panel members, CSU and normocomplementemic UV (NUV) may coexist in some patients.

Conclusions

The use of established criteria for the diagnosis and differential diagnosis of UV in patients with recurrent wheals can help guide the diagnostic approach and prompt earlier treatment. Further studies should investigate whether CSU and NUV are different entities or part of a disease spectrum.

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来源期刊
Clinical and Translational Allergy
Clinical and Translational Allergy Immunology and Microbiology-Immunology
CiteScore
7.50
自引率
4.50%
发文量
117
审稿时长
12 weeks
期刊介绍: Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.
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