Chien-Hung Lin1,2, Peir-Haur Hung3,4, Hsiao-Yun Hu5,6, Chi-Jung Chung7,8, Tsung-Hsien Chen4, Kuan-Yu Hung9. 1. Department of Pediatrics, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan. 2. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. 3. Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan. 4. Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chia-yi City, Taiwan. 5. Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan. 6. Department of Education and Research, Taipei City Hospital, Taipei, Taiwan. 7. Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan. 8. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. 9. Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu City, Taiwan.
Abstract
BACKGROUND: Urticaria is one of the most common diseases seen in clinical practice, whereas several reports have proposed that urticaria may have a link with autoimmune disorders. Few studies have examined the clinical association between urticaria with systemic lupus erythematosus (SLE). By conducting a nationwide population-based case-control study in Taiwan, we evaluated the risk of SLE in children with a prior clinical diagnosis of urticaria. METHODS: Using 2000-2011 claims data from the Taiwanese National Health Insurance Research Database, we identified 2105 SLE children during 2004-2011 as the study group, along with randomly selected 8420 non-SLE patients matched (1:4) for age, sex, and first diagnosis date as the control group. The correlation between urticaria and SLE risk was estimated using conditional logistic regression analysis. RESULTS: The prevalence rates of clinically diagnosed acute and chronic urticaria in SLE patients were 22.09% and 18.24%, respectively. A significant association was found between clinically diagnosed urticaria and childhood SLE, with a stronger risk associated with more episodes of urticaria (≥3 visits, OR: 2.33, 95% CI 1.91-2.84). The risk was higher with chronic urticaria (OR: 2.21, 95% CI 1.85-2.64) than with acute urticaria (OR: 1.54, 95% CI 1.34-1.76). Subgroup analysis stratified by sex or age indicated that the risk associated with SLE was significantly greater among female children and adolescents with urticaria. CONCLUSIONS: Our results suggest that children with urticaria have a significantly higher risk of SLE, with the risk increasing further among those with more episodes of urticaria or chronic urticaria.
BACKGROUND:Urticaria is one of the most common diseases seen in clinical practice, whereas several reports have proposed that urticaria may have a link with autoimmune disorders. Few studies have examined the clinical association between urticaria with systemic lupus erythematosus (SLE). By conducting a nationwide population-based case-control study in Taiwan, we evaluated the risk of SLE in children with a prior clinical diagnosis of urticaria. METHODS: Using 2000-2011 claims data from the Taiwanese National Health Insurance Research Database, we identified 2105 SLEchildren during 2004-2011 as the study group, along with randomly selected 8420 non-SLEpatients matched (1:4) for age, sex, and first diagnosis date as the control group. The correlation between urticaria and SLE risk was estimated using conditional logistic regression analysis. RESULTS: The prevalence rates of clinically diagnosed acute and chronic urticaria in SLEpatients were 22.09% and 18.24%, respectively. A significant association was found between clinically diagnosed urticaria and childhood SLE, with a stronger risk associated with more episodes of urticaria (≥3 visits, OR: 2.33, 95% CI 1.91-2.84). The risk was higher with chronic urticaria (OR: 2.21, 95% CI 1.85-2.64) than with acute urticaria (OR: 1.54, 95% CI 1.34-1.76). Subgroup analysis stratified by sex or age indicated that the risk associated with SLE was significantly greater among female children and adolescents with urticaria. CONCLUSIONS: Our results suggest that children with urticaria have a significantly higher risk of SLE, with the risk increasing further among those with more episodes of urticaria or chronic urticaria.