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EAACI/GA2LEN/EDF/WAO-Leitlinie für die Definition, Klassifikation, Diagnose und das Management der Urtikaria — konsentierte, deutschsprachige Übersetzung

Leitlinie der European Academy of Allergology and Clinical Immunology (EAACI), des Global Allergy and Asthma European Network (GA2LEN), des European Dermatology Forum (EDF) und der World Allergy Organization (WAO)

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Abstract

Diese evidenz- und konsensbasierte Leitlinie wurde entsprechend den Methoden der Cochrane und der Grading of Recommendations Assessment, Development and Evaluation (GRADE)-Arbeitsgruppen entwickelt. Die Leitlinien-Konferenz fand am 1. Dezember 2016 statt. Sie ist eine gemeinsame Initiative der European Academy of Allergology and Clinical Immunology (EAACI), dem von der EU gegründeten Global Allergy and Asthma European Network (GA2LEN), dem European Dermatology Forum (EDF) und der World Allergy Organization (WAO) mit 48 teilnehmenden Delegierten aus 42 nationalen und internationalen Gesellschaften.

Die Leitlinie ist von der European Union of Medical Specialists (UEMS) akzeptiert worden. Urtikaria ist eine häufige, mastzellabhängige Erkrankung, die mit Quaddeln, Angioödemen oder beidem einhergeht. Die Lebenszeitprävalenz der akuten Urtikaria liegt bei circa 20 %. Chronische spontane Urtikaria (CSU) und andere chronische Formen der Urtikaria sind belastend, beeinträchtigen die Lebensqualität und haben einen negativen Einfluss auf die Leistungsfähigkeit in Beruf und Schule. Diese Leitlinie umfasst die Definition und Klassifikation der Urtikaria unter Berücksichtigung der jüngsten Fortschritte in der Identifikation von Ursachen, Auslösefaktoren und Pathomechanismen. Darüber hinaus skizziert sie evidenzbasierte, diagnostische und therapeutische Ansätze für die verschiedenen Subtypen der Urtikaria.

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Abbreviations

AAS:

Angioödem-Aktivitätsscore

ACE:

Angiotensin-Converting Enzym

AE-QoL:

Angioödem-Lebensqualitätsfragebogen

AGREE:

Appraisal of Guidelines Research and Evaluation

AOSD:

Adult-onset Still’s disease

ARIA:

Allergic Rhinitis and its Impact on Asthma

ASST:

Autologer Serum-Hauttest

CAPS:

Kryopyrin-assoziierte periodische Syndrome

CIndU:

Chronische induzierbare Urtikaria

CSU:

Chronische spontane Urtikaria

CU:

Chronische Urtikaria

CU-Q2oL:

CU-Lebensqualitätsfragebogen

CYP:

Cytochrom P

EAACI:

European Academy of Allergy and Clinical Immunology

EDF:

European Dermatology Forum

EtD:

Evidence-to-decisions

FCAS:

Familiäres autoinflammatorisches Kältesyndrom

GA2LEN:

Global Asthma and Allergy European Network

GDT:

Guideline Development Tool

GRADE:

Grading of Recommendations Assessment, Development and Evaluation

HAE:

Hereditäres Angioödem

HIDS:

Hyper-IgD-Syndrom

IVIG/IGIV:

Intravenöse Immunglobuline

MWS:

Muckle-Wells-Syndrom

NOMID:

Neonatale beginnende entzündliche Systemerkrankung

NSAID:

Nichtsteroidale entzündungshemmende Medikamente

PAF:

Thrombozytenaktivierungsfaktor

PET:

Positronen-Emissions-Tomographie

PICO:

Protokoll für die Recherche der Evidenz, das Akronym steht für Patient/Problem/Population, Intervention, Comparison/Control/Comparator, Outcome

REM:

Rapid eye movement

sgAH:

Antihistaminikum der zweiten Generation

sJIA:

Systemisch auftretende juvenile idiopathische Arthritis

TRAPS:

Tumornekrosefaktor-Rezeptor-assoziiertes periodisches Syndrom

UAS:

Urtikaria-Aktivitäts-Score

UCT:

Urtikaria-Kontroll-Test

UEMS:

European Union of Medical Specialists

UV:

Ultraviolett

WAO:

World Allergy Organization

WHO:

World Health Organization

ZNS:

Zentrales Nervensystem

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Authors and Affiliations

  1. Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité — Universitätsmedizin Berlin, kooperatives Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

    Torsten Zuberbier, Martin K. Church, Markus Magerl, Martin Metz, Marcus Maurer & Joachim Fluhr

  2. Department of Dermatology, Medical University of Graz, Graz, Austria

    Werner Aberer

  3. Department of Allergology, Clinica San Carlo, Paderno Dugnano, MI, Italy

    Riccardo Asero

  4. Allergy & Immunology Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

    Amir Hamzah Abdul Latiff

  5. Baker Allergy Asthma and Dermatology Clinic, Portland, OR, USA

    Diane Baker

  6. Allergy Unit, Department of Dermatology, University Hospital, Zürich, Switzerland

    Barbara Ballmer-Weber & Peter Schmid-Grendelmeier

  7. University of Cincinnati Physicians Immunology Research Center, Cincinnati, OH, USA

    Jonathan A. Bernstein

  8. Department of Dermatology and Allergy Centre, Odense University Hospital and University of Southern Denmark, Odense, Denmark

    Carsten Bindslev-Jensen

  9. Department of Internal Diseases, Allergology and Clinical Immunology in Katowice, Medical University of Silesia, Katowice, Poland

    Zenon Brzoza

  10. Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil

    Roberta Buense Bedrikow

  11. Personalized Medicine Asthma and Allergy Clinic-Humanitas University & Research Hospital, Milano, Italy

    Giorgio Walter Canonica

  12. Department of Medicine and Pediatrics, Penn State University, Hershey Medical Center, Hershey, PA, USA

    Timothy Craig

  13. National Research Center — Institute of Immunology Federal Medical-Biological Agency of Russia, Moscow, Russia

    Inna Vladimirovna Danilycheva

  14. Charité — Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Division of Evidence Based Medicine, Department of Dermatology, Berlin, Germany

    Corinna Dressler, Alexander Nast, Stefanie Rosumeck & Ricardo N. Werner

  15. Federal University of Sao Paulo, Sao Paulo, Brazil

    Luis Felipe Ensina

  16. Hospital del Mar, IMIM, Universitat Aut_onoma Barcelona, Barcelona, Spain

    Ana Giménez-Arnau

  17. Department of Dermatology, Dr. D. Y. Patil Medical College & Hospital, Nerul, Navi Mumbai, India

    Kiran Godse

  18. Clinic of Dermatology, Faculty of Medicine and University Hospital, Coimbra, Portugal

    Margarida Goncalo

  19. St John’s’ Institute of Dermatology, Guy’s’ and St. Thomas’ Hospital, NHS Foundation Trust, London, UK

    Clive Grattan

  20. Service d’allergie, Centre Hospitalier Université Laval/Centre Hospitalier Universitaire de Québec, Québec, QC, Canada

    Jacques Hebert

  21. Department of Dermatology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Michihiro Hide

  22. Department of Medicine, Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston, SC, USA

    Allen Kaplan

  23. Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany

    Alexander Kapp & Bettina Wedi

  24. Campbelltown Hospital and Western Sydney University, Sydney, Australia

    Constance H. Katelaris

  25. Department of Dermatology, Okmeydani Training and Research Hospital, Istanbul, Turkey

    Emek Kocatürk

  26. Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Kanokvalai Kulthanan

  27. Hospital Médica Sur, Mexico City, Mexico

    Désirée Larenas-Linnemann

  28. Royal Free Hospital, London, UK

    Tabi A. Leslie

  29. Department of Dermatology and Allergy, University Hospital of Tenon, Paris, France

    Pascale Mathelier-Fusade

  30. Department of Clinical Immunology and Allergy, Smolensk State Medical University, Smolensk, Russia

    Raisa Y. Meshkova

  31. Scuola e Cattedra di Allergologia e Immunologia Clinica, Dipartimento dell’Emergenza e dei Trapianti d’Organo, Università di Bari, Bari, Italy

    Eustachio Nettis

  32. University of Groningen, Groningen, The Netherlands

    Hanneke Oude-Elberink

  33. Johns Hopkins Asthma and Allergy Center, Baltimore, MD, USA

    Sarbjit S. Saini

  34. Allergy and Clinical Immunology Department, Centro Médico-Docente La Trinidad, Caracas, Venezuela

    Mario Sánchez-Borges

  35. Department of Dermatology, University Medical Center Mainz, Mainz, Germany

    Petra Staubach

  36. Division of Allergy and Clinical Immunology, University of Toronto, Toronto, ON, Canada

    Gordon Sussman

  37. Bnai-Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel

    Elias Toubi

  38. Dermatology and Venereology Private Practice, Bari and Barletta, Italy

    Gino A. Vena

  39. Department of Dermatology and Venereology, Aarhus University Hospital, Aarhus, Denmark

    Christian Vestergaard

  40. Department of Dermatology and Venereology, Peking University, First Hospital, Beijing, China

    Zuotao Zhao

  41. Allergologie, Berufsdermatologie und Umweltmedizin, Klinik für Hautkrankheiten, Universitätsklinikum Münster, Münster, Deutschland

    Randolf Brehler

  42. Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Deutschland

    Knut Brockow

  43. Department of Dermatology and Allergology, Cantonal Hospital Aarau, Aarau, Schweiz

    Jürgen Grabbe

  44. Klinik für Kinder- und Jugendmedizin, Kinderzentrum Bethel, Evangelisches Klinikum Bethel, Bethel, Deutschland

    Eckard Hamelmann

  45. Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

    Karin Hartmann

  46. Department of Dermatology and Allergology, University Medical Center Gießen-Marburg, Justus Liebig University Gießen, Gießen, Deutschland

    Thilo Jakob

  47. Allergy Research Group, Department of Dermatology, University Freiburg Medical Center, Freiburg, Deutschland

    Thilo Jakob

  48. Department of Dermatology and Allergology, University Hospital Aachen, Aachen, Deutschland

    Hans Merk

  49. Department of Infection and Immunity, Luxembourg Institute of Health (LIH), Strassen, Luxembourg

    Markus Ollert

  50. Pädiatrische Dermatologie und Allergologie, Kinder- und Jugendkrankenhaus AUF DER BULT, Hannover, Deutschland

    Hagen Ott

  51. Dietary Counseling and Nutrition Therapy with Specialization in Allergology, München, Deutschland

    Imke Reese

  52. Department of Dermatology, Allergology and Venereology, Department of Immunodermatology and Experimental Allergology, Hannover Medical School (MHH), Hannover, Deutschland

    Thomas Werfel

  53. Allergie-Centrum-Charité Klinik für Dermatologie, Venerologie und Allergologie, Charité — Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    Torsten Zuberbier

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  1. Torsten Zuberbier
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  2. Werner Aberer
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  4. Amir Hamzah Abdul Latiff
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  5. Diane Baker
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  6. Barbara Ballmer-Weber
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  7. Jonathan A. Bernstein
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  8. Carsten Bindslev-Jensen
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  9. Zenon Brzoza
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  10. Roberta Buense Bedrikow
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  11. Giorgio Walter Canonica
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  12. Martin K. Church
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  13. Timothy Craig
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Corresponding author

Correspondence to Torsten Zuberbier.

Additional information

Unterstützt von den folgenden Gesellschaften: AAAAI, AAD, AAIITO, ACAAI, AEDV, APAAACI, ASBAI, ASCIA, BAD, BSACI, CDA, CMICA, CSACI, DDG, DDS, DGAKI, DSA, DST, EAACI, EIAS, EDF, EMBRN, ESCD, GA2LEN, IAACI, IADVL, JDA, NVvA, MSAI, €OGDV, PSA, RAACI, SBD, SFD, SGAI, SGDV, SIAAIC, SIDeMaST, SPDV, TSD, UNBB, UNEV and WAO*

Für die folgenden Gesellschaften: Ärzteverband Deutscher Allergologen (AeDA), Deutsche Dermatologische Gesellschaft (DDG), Deutsche Gesellschaft für Allergologie und klinische Immunologie (DGAKI), European Academy of Allergy and Clinical Immunology (EAACI), European Dermatology Forum (EDF), European Mast Cell and Basophil Research Network (EMBRN), Global Allergy and Asthma European Network (GA2LEN), Gesellschaft für pädiatrische Allergologie und Umweltmedizin (GPA), Österreichische Gesellschaft für Dermatologie und Venerologie (ÖGDV), Schweizerische Gesellschaft für Allergologie und Immunologie (SGAI), Schweizerische Gesellschaft für Dermatologie und Venerologie (SGDV), Urtikaria Netzwerk Berlin.Brandenburg (UNBB), Urtikaria Netzwerk e.V. (UNEV), Gesellschaft für Dermatopharmazie (GD), BerufsVerband Oecotrophologie e.V. (VDOE)

*Wichtig: Da es sich um eine globale Richtlinie handelt, wird kein Kommentar zur Zulassung der genannten Medikamente zur Behandlung der Urtikaria abgegeben. Es ist die Pflicht des behandelnden Arztes, sich an die jeweiligen lokalen Vorschriften zu halten.

Danksagung (Originalleitlinie)

Die Autoren danken den Ärzten und Fachleuten, die zum Gelingen der Entwicklung dieser Überarbeitung und Aktualisierung der Leitlinien durch aktive Teilnahme am demokratischen Prozess und der Diskussion im Rahmen des 5. Internationales Konsensmeeting zur Urtikaria 2016 beigetragen haben. Sie danken auch allen nationalen Gesellschaften für die Finanzierung ihrer Delegierten, und Tamara Dörr für ihre erhebliche Hilfe bei der Erstellung dieses Manuskripts. GA2LEN-UCARE-Netzwerk (http://www.ga2len-ucare.com).

Unterstützende Gesellschaften: AAAAI, Amerikanische Akademie für Allergologie, Asthma & Immunologie (mit Kommentaren); AAD, Amerikanische Akademie für Dermatologie; AAIITO, Italienischer Verband von Spital- und Territorialen Allergologen und Immunologen; ACAAI, Amerikanisches College für Allergologie, Asthma und Immunologie; AEDV, Spanische Akademie für Dermatologie und Venerologie; APAAACI, Asien-Pazifik Vereinigung für Allergologie, Asthma und klinische Immunologie; ASBAI, Brasilianische Gesellschaft für A Allergologie llergie und Immunpathologie; ASCIA, Australasiatische Gesellschaft für Klinische Immunologie und Allergologie; BAD, Britischer Verband der Dermatologen; BSACI, Britische Gesellschaft für Allergologie und Klinische Immunologie; CDA, Chinesischer Dermatologenverband; CMICA, Mexikanisches Kolleg für Klinische Immunologie und Allergologie; CSACI, Kanadische Gesellschaft für Allergologie und klinische Immunologie; DDG, Deutsche Gesellschaft für Dermatologie; DDS, Dänische Dermatologische Gesellschaft; DGAKI, Deutsche Gesellschaft für Allergologie und Klinische Immunologie; DSA, Dänische Gesellschaft für Allergologie; DST, Dermatologie Gesellschaft von Thailand; EAACI, Europäische Akademie für Allergologie und Klinische Immunologie; EDF, Europäisches Dermatologie Forum; EMBRN, Europäisches Mastzell- und Basophilen Forschungs Netzwerk; ESCD, Europäische Gesellschaft für Kontaktdermatitis; GA2LEN, Globales Europäisches Netzwerk für Allergie und Asthma; IAACI, Israelischer Verband für Allergologie und klinische Immunologie; IADVL, Indischer Verband für Dermatologie, Venerologie und Leprologie; JDA, Japanische Dermatologische Vereinigung; NVvA, Niederländische Gesellschaft für Allergologie (der offizielle Delegierte stimmte der Richtlinie zu, aber zum Zeitpunkt der Veröffentlichung das offizielle Befürwortungsschreiben nicht eingegangen ist. Sobald dies eintrifft, wird ein Update auf der GA2LEN-Website veröffentlicht); MSAI, Malaysische Gesellschaft für Allergologie und Immunologie; ÖGDV, Österreichische Gesellschaft für Dermatologie; PSA, Polnische Gesellschaft für Allergologie; RAACI, Russische Gesellschaft für Allergologie und Klinische Immunologie; SBD, Brasilianische Gesellschaft für Dermatologie; SFD, Französische Gesellschaft für Dermatologie; SGAI, Schweizerische Gesellschaft für Allergologie und Immunologie; SGDV, Schweizerische Gesellschaft für Dermatologie und Venerologie; SIAAIC, Italienische Gesellschaft für Allergologie, Asthma und Klinische Immunologie; SIDeMaST, Italienische Gesellschaft für Medizinische, Chirurgische und Ästhetische Dermatologie und sexuell übertragbare Krankheiten; SPDV, Portugiesische Gesellschaft für Dermatologie und Venerologie; TSD, Türkische Gesellschaft für Dermatologie; UNBB, Urtikaria-Netzwerk Berlin-Brandenburg; UNEV, Urtikaria Netzwerk; WAO, Weltallergieorganisation.

Interessenkonflikte

Bitte beachten Sie die Tabelle im Methodenpapier, in dem die Interessenkonflikte aller Autoren detailliert aufgeführt sind (https://onlinelibrary.wiley.com/doi/abs/10.1111/all.13414).

Der Verlag erklärt, dass die inhaltliche Qualität des Beitrags von zwei unabhängigen Gutachtern geprüft wurde. Werbung in dieser Zeitschriftenausgabe hat keinen Bezug zur CME-Fortbildung. Der Verlag garantiert, dass die CME-Fragen frei sind von werblichen Aussagen und keinerlei Produktempfehlungen enthalten. Dies gilt insbesondere für Präparate, die zur Therapie des dargestellten Krankheitsbildes geeignet sind.

Erstpublikation

Diese Leitlinie ist im Original auf Englisch erschienen: Zuberbier T, Aberer W, Asero R, Abdul Latif AH, Baker D, Ballmer-Weber B et al. Endorsed by the following societies: AAAAI, AAD, AAIITO, ACAAI, AEDV, APAAACI, ASBAI, ASCIA, BAD, BSACI, CDA, CMICA, CSACI, DDG, DDS, DGAKI, DSA, DST, EAACI, EIAS, EDF, EMBRN, ESCD, GA2LEN, IAACI, IADVL, JDA, NVvA, MSAI, €OGDV, PSA, RAACI, SBD, SFD, SGAI, SGDV, SIAAIC, SIDeMaST, SPDV, TSD, UNBB, UNEV and WAO. The EAACI/GA2LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy 2018;73:1393–414

https://doi.org/10.1111/all.13397

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Zuberbier, T., Aberer, W., Asero, R. et al. EAACI/GA2LEN/EDF/WAO-Leitlinie für die Definition, Klassifikation, Diagnose und das Management der Urtikaria — konsentierte, deutschsprachige Übersetzung. Allergo J 27, 41–69 (2018). https://doi.org/10.1007/s15007-018-1751-3

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