Systemic Histaminergic Findings in Children With Chronic Urticaria

Aim The widespread distribution of mast cells and histamine receptors throughout the body has raised the question of whether this release exerts systemic effects. The aim of this study was to investigate the relationship between systemic findings that may affect quality of life and urine and serum histamine levels in pediatric patients with chronic urticaria (CU). Methods Children with CU and healthy controls were compared in terms of systemic complaints, serum and urinary histamine levels, 24‐h electrocardiogram (ECG) rhythm (Holter) recordings, and 24‐h ambulatory blood pressure monitoring (ABPM). Results Systemic symptoms in patients included peptic discomfort (30.3%), palpitations (15.1%), chest pain (9.1%), dyspnea, joint pain, and headache. While serum histamine levels did not differ, urinary histamine levels were significantly elevated in patients ( p = 0.164 for serum and p < 0.001 for urine). Urinary histamine levels were also significantly higher in patients with peptic symptoms, palpitations, dyspnea, and headache ( p = 0.004, p = 0.019, p = 0.019, and p = 0.008, respectively). Systolic and diastolic blood pressure standard deviation values were significantly higher in patients ( p < 0.05). Urinary histamine levels were higher in patients with rare ST‐T changes ( p = 0.04). There was no significant correlation between the quality‐of‐life questionnaire, urticaria activity scores, and serum or urinary histamine levels ( p > 0.05). Conclusion Identifying systemic symptoms associated with histamine in pediatric CU may help develop more effective and proactive treatment strategies in the early stages of the disease, thereby reducing the overall disease burden. Urinary histamine levels may serve as a useful marker for assessing chronic histamine exposure.