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The diagnostic workup in chronic spontaneous urticaria - what to test and why.

M. Metz,S. Altrichter,T. Buttgereit,J. Fluhr,J. Fok,T. Hawro,Q. Jiao,P. Kolkhir,K. Krause,M. Magerl,P. Pyatilova,F. Siebenhaar,Huichun Su,D. Terhorst‐Molawi,K. Weller,Y. Xiang,M. Maurer

Published 2021 in Journal of Allergy and Clinical Immunology: In Practice

ABSTRACT

BACKGROUND In chronic spontaneous urticaria (CSU), the guidelines recommend very limited diagnostic procedures during the routine workup, although additional investigations might be indicated in some CSU patients. For physicians treating CSU patients, it is often difficult to decide which diagnostic tests are useful. OBJECTIVE To provide recommendations on what diagnostic tests should be performed on which CSU patient. METHODS We performed an extensive literature search on the respective topics and identified relevant questions that should prompt diagnostic procedures based on the published evidence and expert consensus among all authors. RESULTS We provide questions, diagnostic testing, where appropriate, and recommendation that should be included when assessing a CSU patient history, to explore and rule out differential diagnoses, to assess patients for underlying causes and modifying conditions, to explore patients for comorbid diseases and consequences of having CSU, and to assess patients for CSU components that can help to predict their disease course and response to treatment. CONCLUSIONS Here, we provide physicians treating CSU patients with information about which clues should lead to which tests and why.

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