D1.295 - Clinical, Laboratory and Prognostic Evaluation of Antinuclear Antibody Positive and Negative Children with Chronic Urticaria

Autoimmune diseases are known to be more prevalent in patients with chronic urticaria (CU) compared to the general population. CU may serve as an indicator of underlying autoimmune disorders. Antinuclear antibody (ANA) positivity could signify the presence of autoimmune processes in pediatric patients with CU. This study aims to evaluate the clinical characteristics, laboratory findings, and prognostic differences between ANA-positive and ANA-negative children with CU.

A retrospective analysis was conducted on 147 children diagnosed with chronic urticaria who underwent ANA testing between January 2015 and December 2024 at the Pediatric Allergy Clinic. Patients were compared based on demographic data, clinical features, laboratory findings, treatment response, and prognosis. Data analysis was performed using SPSS 29.0, with p-values <0.05 considered statistically significant.

Of the 147 patients, 93 (63.3%) were female, with a mean age of 12.06 ± 4.5 years. The female-to-male ratio was 1.72:1. The mean age of symptom onset was 9.4 ± 4.5 years, and the mean age at diagnosis was 9.7 ± 4.5 years. ANA positivity was detected in 66 (44.9%) cases. ANA-positive patients had significantly higher proportions of females, initial urticaria activity scores (UAS), erythrocyte sedimentation rates, presence of autoimmune conditions at urticaria onset, longer disease durations, and higher rates of non-remission at 12 months. Autoimmune diseases, particularly Hashimoto's thyroiditis, were more common during follow-up in ANA-positive cases. There were no significant differences between groups in terms of complete blood counts, CRP, total IgE levels, vitamin D levels, or allergic sensitization. Results are summarized in Table 1.

ANA-positive children with CU are associated with more severe clinical symptoms, higher initial UAS, and poorer prognosis. They also exhibit higher rates of baseline autoimmune diseases and develop autoimmune conditions, such as Hashimoto’s thyroiditis, more frequently during follow-up. Our findings highlight the potential utility of ANA screening in guiding diagnosis and management in pediatric patients with CU.