Effect of Dietary Intervention in Paediatric Patients with Chronic Spontaneous Urticaria: Open Labelled Randomised Controlled Trial.

Chronic spontaneous urticaria (CSU) is a skin disorder characterized by itchy wheal, angioedema or both that persists for over six weeks. 'Pseudoallergens' in food induce hypersensitive reactions similar to true allergic reactions and are linked to CSU. These consist of food additives, vasoactive amines (histamine) and a few natural substances in fruits, vegetables and spices. This study aimed to investigate if dietary restriction (pseudoallergen-free and low histamine diet) can improve the clinical outcome in paediatric CSU patients. The present open-label randomized control trial was conducted in a paediatric tertiary care centre of Eastern India from September 2021 to August 2022. Paediatric CSU patients (n=140) attending the centre were randomly allocated to one of two treatment interventions: DR group (n=70, drug) or DRDI group (n=70, drugs and dietary intervention). Both groups were compared at baseline. The weekly urticaria activity score (UAS7) was calculated by trained parents. All data were entered in an Excel spreadsheet. T-test was used to compare the UAS7 of both groups at baseline, three and six weeks of treatment. There was no significant difference in demographic characteristics, clinical features, laboratory parameters and weekly urticaria activity score (UAS7) between groups at baseline. After six weeks of treatment, the UAS7 of patients in the DRDI group was lower as compared to those in the DR group (8.80±4.27 vs 10.19±4.66), though statistically insignificant (t=1.79, p=0.07). Pseudoallergen-free diet is a safe and cost-effective measure to decrease CSU patients' symptoms.