Concomitant Chronic Urticaria in Children: A Distinct Severe Phenotype
Bibliographic record
Abstract
INTRODUCTION: Chronic spontaneous urticaria (CSU) presents as repetitive spontaneous hives and/or angioedema lasting for at least 6 weeks. In contrast, chronic inducible urticaria (CIndU) is triggered by specific stimuli. This study aimed to characterize children who have concurrent CSU and CIndU excluding children with symptomatic dermographism and to identify factors that distinguish them from children with CSU alone or CIndU alone. METHODS: This prospective cohort study was conducted over an 11-year period, from 2013 to 2024, at Montreal Children's Hospital in Canada. It included pediatric patients aged 0-18 years with chronic urticaria. RESULTS: During the study period, 202 pediatric patients with chronic urticaria were included. Of these, 20 patients (9.9%) had both CSU and CIndU concomitantly. Cold urticaria was the most common CIndU associated with concomitant urticaria group, affecting 9 patients (45%). The mean age of patients with concomitant urticaria was 6.2 years (IQR: 5.0-11.8), and the majority were females (60%). Eight patients (42%) initially presented with CSU alone. Uncontrolled CSU (baseline UAS7 scores ≥16) was more common in patients with concomitant urticaria (60%) versus those with isolated CSU (27.5%) or CIndU (17.2%) (p < 0.01). Omalizumab usage was significantly higher in children with concurrent CSU and CIndU (20%) compared to those with CSU alone (5.9%) or CINDU alone (0%) (p = 0.04 and 0.01, respectively). CONCLUSION: Pediatric patients who have concomitant CSU and CIndU represent a more severe CU phenotype that requires the use of biologics like omalizumab as compared to children with CSU/CIndU alone.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".