Diagnosis and Management of Comorbid Autoimmune Disorders in Children with Chronic Spontaneous Urticaria

Ethan Bendayan,1 Armin Farzad,2 Catherine Keying Zhu,3 Moshe Ben-Shoshan,4,* Elena Netchiporouk2,3,* 1Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada; 2Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC, Canada; 3Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada; 4Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University, Montreal, QC, Canada*These authors contributed equally to this workCorrespondence: Elena Netchiporouk, Division of Dermatology, Department of Medicine, McGill University Health Centre, 1650 Ave Cedar, Montréal, QC, H3G 1A4, Canada, Email [email protected]: Chronic urticaria (CU) is characterized by the recurrent occurrence of wheals and/or angioedema for more than six weeks. CU comprises two principal subtypes: chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU). Increasing evidence suggests that CSU has an autoimmune basis, and patients with CSU exhibit a higher prevalence of concomitant autoimmune disorders. While this association has been well documented in adults, data in pediatric populations remain limited. Available studies indicate that the overall burden of autoimmunity in children with CSU may be lower than in adults; however, several autoimmune diseases—including autoimmune thyroid disease, celiac disease, type 1 diabetes mellitus, vitiligo, systemic lupus erythematosus, and juvenile idiopathic arthritis—have been reported with increased frequency in pediatric CSU cohorts. A clearer understanding of these associations is important for guiding clinical evaluation and management. This review summarizes current evidence on the epidemiology and risk factors for autoimmune comorbidities in pediatric CU and discusses practical considerations for screening and management in affected children.Keywords: chronic urticaria, chronic spontaneous urticaria, autoimmune, pediatric