Kronik Ürtiker Şikayeti İle Başvuran Hastaya Akılcı Yaklaşım

ÖzKronik ürtiker çocuklarda erişkinlere oranlara daha nadir görülmektedir. Kronik ürtiker; kronik spontan ürtiker ve kronik uyarılabilir ürtiker olmak üzere iki ana başlık altında gruplandırılmaktadır. Tedavide ilk basamak tetikleyici faktörlerden uzak durmaktır. Medikal tedavide en çok kullanılan ilaçlar ikinci kuşak antihistaminik ilaçlardır. Antihistaminik tedavisine yanıt alınmadığında doz artışı yapılmalı ve yine yanıt alınamazsa omalizumab ve siklosporin A gibi ek tedavi seçenekleri düşünülmelidir. Burada kronik ürtikerli bir olgudan yola çıkılarak, kronik ürtiker tanı ve tedavi yaklaşımı anlatılmıştır.

Anahtar Kelimeler:

Kronik ürtiker, antihistaminik, omalizumab

Rational Approach to the Patient Presenting with Chronic Urticaria

AbstractChronic urticaria is less common in children than adults. Chronic urticaria, is grouped under two main headings as chronic spontaneous urticaria and chronic inducible urticaria. The first step in treatment is to avoid trigger factors. The most commonlyused drugs in medical treatment are second-generation antihistamines. If there is noresponse to antihistamine treatment, the dose should be increased. If no response isobtained, additional treatment options such as omalizumab and cyclosporin A should be considered. Chronic urticaria diagnosis and treatment approach are describedbased on a case diagnosed chronic urticaria in this article.

Keywords:

Chronic urticaria, antihistamine, omalizumab,

PDF

___

Kaynaklar 1. Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, etal. The EAACI/GA²LEN/EDF/WAO guideline for the defini-tion, classification, diagnosis and management of urticaria.Allergy. 2018 Jul;73(7):1393-1414. 2. Kocatürk Goncü E, Aktan S, Atakan N, Bülbül Baskan E, Er-dem T, Koca R, et al. The Turkish guideline for the diagnosisand management of urticaria-2016. Turkderm e Arch Turk Der-matol Venerol 2016;50:82e98. 3. Fraser K, Robertson L. Chronic urticaria and autoimmunity.Skin Therapy Lett. 2013;18(7):5-9. 4. Stull D, McBride D, Georgiou P, Zuberbier T, Grattan C, BalpM-M: Measuring patient severity in chronic spontaneous/idio-pathic urticaria (CSU/CIU) as categorical health states: ef-ficient and informative? Allergy 2014;69(suppl 99):317. 5. Cavkaytar O, Arik Yilmaz E, Buyuktiryaki B, Sekerel BE, Sac-kesen C, Soyer OU. Challenge-proven aspirin hypersensiti-vity in children with chronic spontaneous urticaria. Allergy.2015 Feb;70(2):153-60. 6. Harmancı K, Arga M, Uysal P, Asilsoy S, Çetinkaya F et al.Turkish National Society of Allergy and Clinical ImmunologyPosition Paper: Diagnosis and Management of Urticaria. Asth-ma Allergy Immunol 2018; 16:Supplement: 2, 97-122 7. Simons FE, Simons KJ. Histamine and H1-antihistamines: ce-lebrating a century of progress. J Allergy Clin Immunol.2011;128(6):1139-1150. 8. Powell RJ, Leech SC, Till S, Huber PA, Nasser SM, Clark AT;British Society for Allergy and Clinical Immunology. BSACIguideline for the management of chronic urticaria and angi-oedema. Clin Exp Allergy. 2015 Mar;45(3):547-65. 9.Bernstein JA, Lang DM, Khan DA, Craig T, Dreyfus D, et al. Thediagnosis and management of acute and chronic urticaria: 2014update. J Allergy Clin Immunol. 2014 May;133(5):1270-7.