Chronic urticaria in children.

Chronic urticaria (CU) in children often is caused by physical triggers. It also can be associated with autoimmune disease, especially thyroid autoimmunity. Functional autoantibodies against FcepsilonRIalpha have been reported in children with CU but have not been studied in a systematic fashion. The autologous serum skin test has been proposed as a surrogate test to define the presence of these autoantibodies, although it identifies the presence of histamine-releasing factor, not necessarily antibody. Second-generation antihistamines usually are preferred for chronic therapy. Leukotriene receptor antagonists may be of benefit in a subset of children with CU.