Headache deteriorates the quality of life in children with chronic spontaneous urticaria*
Main Article Content
Keywords
Chronic urticaria, Headache, Quality of life
Abstract
Background: Quality of life, which is impaired in patients with chronic spontaneous urticaria (CSU), is influenced by comorbid mental disorders. Headaches could be another comorbid mental disorder that affects quality of life in children with CSU.
Objectives: To investigate the effect of headaches on urticaria symptoms, disease activity and quality of life in children with CSU.
Methods: A total of 83 patients with CSU were enrolled in the study and were separated into two groups as those with or without headache. Demographic and clinical characteristics were studied with the Urticaria Activity Score (UAS7), Urticaria Control test (UCT) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2QoL). The headache questionnaire designed according to the Department of International Classification of Headache Disorders, second edition (ICHD-II) was used and VAS (Visual Analogue Scale) and NRS (Numerical Rating Scale) were used to assess the pain measurement. In patients diagnosed with migraine, the paediatric Migraine Disability Assessment Scale (PedMIDAS) was applied.
Results: CU-QoL total scores were significantly higher in patients with CSU with headache than in those without headache (p = 0.015). In the five domains of CU-QoL, impact of daily life activities domain and sleep problems domain had higher scores in CSU with headache (p = 0.008, 0.028, respectively). There was no significant relationship between UCT, UAS and CU-QoL and headache severity (p < 0.05). No differences were found between the groups in respect of duration of urticaria, UAS7 and UCT.
Conclusion: Headache may be an important factor that affects and impairs quality of life in children with chronic urticaria.
References
2. Kaplan AP. Chronic urticaria and angioedema. N Engl J Med. 2002;346:175-9.
3. Cornillier H, Giraudeau B, Munck S, Hacard F, Jonville-Bera AP, d’Acremont G, et al. Chronic spontaneous urticaria in children - a systematic review on interventions and comorbidities. Pediatr Allergy Immunol. 2018;29:303-10.
4. Konstantinou GN, Papadopoulos NG, Tavladaki T, Tsekoura T, Tsilimigaki A, Grattan CE. Childhood acute urticaria in northern and southern Europe shows a similar epidemiological pattern and significant meteorological influences. Pediatr Allergy Immunol. 2011;22:36-42.
5. Du Toit G, Prescott R, Lawrence P, Johar A, Brown G, et al. Autoantibodies to the high-affinity IgE receptor in children with chronic urticaria. Ann Allergy Asthma Immunol. 2006;96:341-4.
6. Netchiporouk E, Sasseville D, Moreau L, Habel Y, Rahme E, Ben-Shoshan M. Evaluating comorbidities, natural history, and predictors of early resolution in a cohort of children with chronic urticaria. JAMA Dermatol. 2017;153:1236-42.
7. Chansakulporn S, Pongpreuksa S, Sangacharoenkit P, Pacharn P, Visitsunthorn N, Vichyanond P, et al. The natural history of chronic urticaria in childhood: a prospective study. J Am Acad Dermatol. 2014;71:663-8.
8. Langdon R, DiSabella M. Pediatric headache: an overview. Curr Probl Pediatr Adolesc Health Care. 2017;47:44-65.
9. Blume HK. Childhood headache: a brief review. Pediatr Ann. 2017;46:155-65.
10. Aupiais C, Wanin S, Romanello S, Spiri D, Moretti R, Boizeau P, et al. Association between migraine and atopic diseases in childhood: a potential protective role of anti-allergic drugs. Headache. 2017;57:612-24.
11. Jensen R. Pathophysiological mechanisms of tension-type headache: a review of epidemiological and experimental studies. Cephalalgia. 1999;19:602-21.
12. Theoharides TC, Donelan JM, Papadopoulou N, Cao J, Kempuraj D, Conti P. Mast cells as targets of corticotropin-releasing factor and related peptides. Trends Pharmacol Sci. 2004;25:563-8.
13. Ben-Shoshan M, Blinderman I, Raz A. Psychosocial factors and chronic spontaneous urticaria: a systematic review. Allergy. 2013;68:131-41.
14. Staubach P, Dechene M, Metz M, Magerl M, Siebenhaar F, Weller K, et al. High prevalence of mental disorders and emotional distress in patients with chronic spontaneous urticaria. Acta Derm Venereol. 2011;91:557-61.
15. Maurer M, Abuzakouk M, Bérard F, Canonica W, Oude Elberink H, Giménez-Arnau A, et al. The burden of chronic spontaneous urticaria is substantial: real-world evidence from ASSURE-CSU. Allergy. 2017;72:2005-16.
16. Weldon D. Quality of life in patients with urticaria and angioedema: assessing burden of disease. Allergy Asthma Proc. 2014;35:4-9.
17. Church MK, Weller K, Stock P, Maurer M. Chronic spontaneous urticaria in children: itching for insight. Pediatr Allergy Immunol. 2011;22:1-8.
18. Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014;69:868-87.
19. Weller K, Groffik A, Church MK, Hawro T, Krause K, Metz M, et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. 2014;133:1365-72.
20. Kocaturk E, Weller K, Martus P, Aktas S, Kavala M, Sarigul S, et al. Turkish version of the chronic urticaria quality of life questionnaire: cultural adaptation, assessment of reliability and validity. Acta Derm Venereol. 2012;92:419-25.
21. Hershey AD, Powers SW, Vockell AL, LeCates SL, Segers A, Kabbouche MA. Development of a patient-based grading scale for PedMIDAS. Cephalalgi. 2004;24:844-9.
22. Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, et al. Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011;41:1073-93.
23. Sabroe RA, Grattan CE, Francis DM, Barr RM, Kobza Black A, Greaves MW. The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. Br J Dermatol. 1999;140:446-52.
24. Staubach P, Eckhardt-Henn A, Dechene M, Vonend A, Metz M, Magerl M, et al. Quality of life in patients with chronic urticaria is differentially impaired and determined by psychiatric comorbidity. Br J Dermatol. 2006;154:294-8.
25. Hergüner S, Kilic¸ G, Karakoc¸ S, Tamay Z, Tüzün U, Güler N. Levels of depression, anxiety and behavioural problems and frequency of psychiatric disorders in children with chronic idiopathic urticaria. Br J Dermatol. 2011;164:1342-7.
26. Doong JC, Chichester K, Oliver ET, Schwartz LB, Saini SS. Chronic idiopathic urticaria: systemic complaints and their relationship with disease and immune measures. J Allergy Clin Immunol Pract. 2017;5:1314-8.
27. Malhotra R. Understanding migraine: potential role of neurogenic inflammation. Ann Indian Acad Neurol. 2016;19:175-82.
28. Yuan H, Silberstein SD. Histamine and migraine. Headache. 2018:58184-93.
29. Guidetti V, Faedda N, Siniatchkin M. Migraine in childhood: biobehavioural or psychosomatic disorder? J Headache Pain.
2016;17:82.
30. Tedeschi A, Kolkhir P, Asero R, Pogorelov D, Olisova O, Kochergin N, et al. Chronic urticaria and coagulation: pathophysiological and clinical aspects. Allergy. 2014;69:683-91.
31. Georgin-Lavialle S, Gaillard R, Moura D, Hermine O. Mastocytosis in adulthood and neuropsychiatric disorders. Transl Res. 2016;174:77-85.
32. Özge A, Öksüz N, Ayta S, Uluduz D, Yıldırım V, Toros F, et al. Atopic disorders are more common in childhood migraine and correlated headache phenotype. Pediatr Int. 2014;56: 868-72.
33. Blaiss MS, Hammerby E, Robinson S, Kennedy-Martin T, Buchs S. The burden of allergic rhinitis and allergic rhinoconjunctivitis on adolescents: a literature review. Ann Allergy Asthma Immunol. 2018;121:43-52.
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