. 2022 Oct 20;15:1455–1490. doi: 10.2147/JAA.S379912

Table 5.

Comparison of the Reported Demographic and Clinical Characteristics of Elderly Patients with Chronic Urticaria (CU) with Those of Non-Elderly

Clinical features: N/Total (%)	Elderly (our systematic review)	Non-elderly
Demographic Data
Prevalence of CU in population	22,900/9,757,210 (0.2) – 13,476/488,145 (2.8)²⁹^,³³^,³⁵^,⁴⁶	6019/7,555,991 (0.1) – 90/2613 (3.4)⁹^,¹⁹^,²⁹^,³⁰^,³³^,⁹⁸^,^134–140
CSU proportion in CU	127/153 (83.0) – 63/65 (96.9)¹⁰^,²⁰^,⁴⁵	145/220 (66.0) – 215/231 (93.1)²⁶^,³⁴^,⁷⁴^,^108–111^,^141–146
CIndU proportion in CU	2/65 (3.1) – 26/153 (17.0)¹⁰^,²⁰^,³²^,⁴⁵	17/329 (5.2) – 75/220 (34.0)²⁶^,⁷⁴^,^108–111^,^141–146
Sex ratio (Male: Female)	1: 0.9–3.3^10–12^,^20–25^,^30–33^,³⁷^,³⁹^,⁴⁰^,⁴⁵^,⁹⁰	1: 1.0–5.7¹⁰^,¹²^,¹⁹^,^28–30^,³³^,³⁴^,^36–38^,⁴⁰^,⁴¹^,⁷⁴^,¹⁰⁰^,¹⁰⁹^,¹¹⁴^,¹³⁰^,¹³¹^,¹³⁴^,¹³⁶^,¹³⁹^,^142–144^,^147–163
Clinical presentation
Wheal alone	10/30 (33.3) – 86/99 (86.9)¹⁰^,¹²^,²⁰^,³⁷^,⁴⁰^,⁹⁰	96/330 (29.1) – 77/102 (75.5)¹²^,²⁰^,⁴⁰^,¹⁰⁷^,¹⁰⁹^,¹³⁶^,¹⁴¹^,¹⁴³^,¹⁴⁷^,¹⁴⁹^,^163–168
Wheal with angioedema	13/99 (13.1) – 20/30 (66.7)¹⁰^,¹²^,²⁰^,³⁷^,⁴⁰^,⁹⁰	17/248 (6.9) – 152/199 (76.4)¹²^,²⁸^,^36–40^,⁷⁴^,¹⁰⁹^,¹¹¹^,¹²⁰^,¹³⁶^,¹⁴¹^,¹⁴³^,¹⁴⁷^,¹⁴⁹^,¹⁵⁸^,¹⁵⁹^,¹⁶³^,^165–173
Wheal with anaphylaxis ^a	1/1 (100.0)⁵⁶	0/2,175 (0.0)²⁸^,¹⁷⁴^,¹⁷⁵
Personal history of atopy	2/92 (2.2) – 9/26 (34.6)¹⁰^,¹¹^,²⁰^,³⁷^,⁴⁵^,⁶⁴^,⁹⁰	171/13,479 (1.3) −101/147(68.7)¹¹^,¹²^,²⁸^,^34–38^,⁷⁴^,¹⁰⁰^,¹⁰⁶^,¹¹⁴^,¹⁴⁷^,¹⁵⁹^,¹⁶⁰^,¹⁶³^,^176–179
Comorbidities
Gastrointestinal diseases	5/104 (4.8) – 708,415/985,278 (71.9)²⁰^,⁶⁴	127/12,185 (1.0) – 145/330 (44.0)¹²^,²⁸^,¹⁰⁰^,¹¹¹^,¹³¹^,¹⁷⁸^,^180–182
Metabolic syndrome	21/63 (33.3) – 44/92 (47.8)²⁰^,⁹⁰	276/12/185 (2.3) – 1,741/11,261 (15.5)¹⁰⁰^,¹¹⁴^,¹¹⁶
Thyroid diseases	1/67 (1.5) – 19/99 (19.2)¹⁰^,²⁰^,³⁷^,⁴⁵	34/13,479 (0.3) – 20/47 (42.5)¹²^,²⁸^,³⁰^,^35–37^,⁶⁷^,⁷⁰^,¹⁰⁰^,¹⁵³^,¹⁵⁹^,¹⁶⁵^,^170–172^,¹⁷⁸^,¹⁸³^,¹⁸⁴
Autoimmune diseases	8/63 (12.7)⁹⁰	40/12,185 (0.3) –25/209 (12.0)³⁰^,¹⁰⁰^,¹⁵³^,¹⁵⁹^,¹⁷⁰^,¹⁷²
Psychiatric problems
Anxiety disorders	NA	266/13,479 (2.0) – 24/30 (80.0)³⁵^,¹³⁹^,^185–189
Depression & other psychiatric problems	2/99 (2.0) – 2/26 (7.7)³⁷^,⁴⁵^,⁶⁵	121/12,185 (1.0) – 21/30 (70.0)¹²^,³⁰^,³⁶^,³⁷^,¹⁰⁰^,¹³⁹^,¹⁴⁸^,¹⁵⁴^,¹⁵⁹^,^185–187^,^189–192
Malignancies
Hematologic malignancy ^b	33/3,615 (0.9)¹⁹	80/36,910 (0.2) – 25/9,105 (0.3)¹⁸^,¹⁹
Other	415/3,615 (11.5) – 11/92 (12.0)¹⁹^,²⁰	231/9,105 (0.3) – 330/13,479 (2.5)¹⁸^,¹⁹^,³⁵^,¹⁴⁸
Most common subtype of CIndU	Symptomatic dermographism¹⁰^,²⁰^,⁴⁵	Symptomatic dermographism¹⁰^,³⁶^,³⁷^,⁷⁴^,¹⁰⁸^,¹¹¹^,^193–195
Laboratory investigations
Positive antinuclear antibodies	13/63 (20.6) of CSU¹⁰	248/12,778 (1.9) – 131/195 (67.2) of CSU¹⁰^,¹²⁰^,¹⁵⁵^,¹⁵⁸^,¹⁶⁰^,¹⁹⁶^,¹⁹⁷
Elevated erythrocyte sedimentation rate	18/63 (28.6)¹⁰	3/184 (1.6) – 65/133 (48.9)¹⁰^,⁷⁴^,¹⁵⁵^,¹⁶⁰^,¹⁶⁵^,¹⁷²^,¹⁷⁸^,¹⁹⁸
Elevated total serum IgE ^c	NA	14/330 (4.2) – 34/62 (54.8)¹²^,²⁸^,³⁶^,⁷⁴^,¹⁶⁵^,^199–201
Positive ASST	11/61 (18.0) – 3/5 (60.0) of CSU²⁰^,³⁷^,⁴⁰^,⁴²	12/45 (26.7) – 49/67 (73.1) of CSU¹⁰^,²⁸^,³⁶^,³⁷^,⁴⁰^,⁷⁴^,¹⁰⁸^,¹¹¹^,¹³⁰^,¹⁴²^,¹⁵⁰^,¹⁵⁵^,¹⁵⁶^,¹⁶⁰^,¹⁶⁸^,¹⁹⁶^,^202–211
Abnormal thyroid function test ^c	NA	20/330 (6.1) – 20/66 (30.3)¹²^,³⁸^,⁶⁷^,⁷⁰^,⁷⁸^,¹⁹⁸^,²¹²^,²¹³
Abnormal free T3 ^c	NA	1/56 (1.8) – 99/165 (60.0)⁷⁴^,²¹⁴
Abnormal free T4 ^c	NA	97/165 (58.8)⁷⁴
Abnormal TSH ^c	NA	2/56 (3.6) – 99/167 (59.3)⁷⁴^,¹⁶⁵^,¹⁷¹^,¹⁸³^,²¹⁴^,²¹⁵
Positive thyroid autoantibodies	3/24 (12.5) – 21/63 (33.3)¹⁰^,¹¹^,⁴⁰	3/79 (3.8) – 27/47 (57.5)¹⁰^,¹¹^,³⁶^,⁴⁰^,⁶⁷^,⁷⁰^,⁷¹^,⁷³^,⁷⁴^,¹⁰⁶^,¹⁰⁹^,¹²⁰^,¹³⁰^,¹⁵³^,^155–157^,¹⁶⁰^,¹⁶¹^,¹⁶³^,¹⁶⁵^,¹⁶⁸^,^170–173^,¹⁸³^,¹⁸⁴^,¹⁹⁶^,¹⁹⁸^,¹⁹⁹^,^201–203^,²⁰⁷^,^209–237
Positive HBsAg	8/63 (12.7)¹⁰	0/121 (0.0) – 2/56 (3.6)¹⁰^,²⁸^,¹¹¹^,¹²⁸^,¹²⁹^,¹⁹²^,²³⁸
Duration of disease prior to diagnosis (years)	0.2–2.0³⁹^,⁶⁰^,⁶⁷^,⁶⁹^,⁷⁹^,⁸⁵^,⁸⁷	3.2–6.3⁸⁷^,¹⁷²
Treatment
Response to 1^st line (standard dose AH₁)	17.045/99 (45.5) – 23/26 (88.5)³⁷^,³⁸^,⁴⁵	164/516 (31.8) – 163/248 (65.9)^36–39^,¹⁶⁰^,¹⁷⁰
Needed 2^nd line	3/26 (11.5) – 24/96 (25.0)³⁷^,⁴⁵	36/335 (10.8) – 199/569 (34.9)³⁶^,³⁷^,¹⁷⁰^,¹⁷²
Needed 3^rd line	5/32 (15.6) – 28/95 (29.5)³⁷^,⁴⁰	36/361 (10.0) – 93/329 (28.3)³⁶^,³⁷^,⁴⁰^,⁷⁴^,¹⁰⁸^,¹⁵⁹^,¹⁷²^,¹⁷⁸

Notes: ^aWheal with anaphylaxis in elderly was found in only one case report of cold urticaria. ^bIt should be noted that the only retrospective study which reported malignancy in population was from Chen et al ^cProportion of elevated IgE, abnormal thyroid function test, free T3, free T4, and TSH in elderly patients were reported in only case reports and case series. No prospective or retrospective cohort study was found.

Abbreviations: ASST, autologous serum skin test; CIndU, chronic inducible urticaria; CSU, chronic spontaneous urticaria; CU, chronic urticaria; HBsAg, hepatitis B surface antigen; NA, not available/not applicable; TSH, thyroid stimulating hormone.