Hong Kong–Macau Severe Hives and Angioedema Referral Pathway
BackgroundUrticaria (defined as the presence of hives, angioedema, or both) can be caused by a variety of etiologies ranging from more common conditions such as chronic spontaneous urticaria (CSU) to rarer conditions such as hereditary angioedema (HAE). Specialist referral may be necessary in cases...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Allergy |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/falgy.2023.1290021/full |
| _version_ | 1797403360782974976 |
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| author | Philip H. Li Elaine Y. L. Au Si-Leong Cheong Ling Chung Ka I. Fan Marco H. K. Ho Agnes S. Y. Leung Agnes S. Y. Leung Martin M. H. Chung Jane C. Y. Wong Ricardo Coelho |
| author_facet | Philip H. Li Elaine Y. L. Au Si-Leong Cheong Ling Chung Ka I. Fan Marco H. K. Ho Agnes S. Y. Leung Agnes S. Y. Leung Martin M. H. Chung Jane C. Y. Wong Ricardo Coelho |
| author_sort | Philip H. Li |
| collection | DOAJ |
| description | BackgroundUrticaria (defined as the presence of hives, angioedema, or both) can be caused by a variety of etiologies ranging from more common conditions such as chronic spontaneous urticaria (CSU) to rarer conditions such as hereditary angioedema (HAE). Specialist referral may be necessary in cases of severe urticaria or HAE, but access to specialist services remains limited in certain regions, such as the Greater Bay Area (GBA) of China. To address this, the Hong Kong–Macau Severe Hives and Angioedema Referral Pathway (SHARP) was initiated by the Hong Kong Institute of Allergy and Macau Society of Dermatology to promote multidisciplinary collaboration and regional exchange of expertise in the diagnosis and management of severe urticaria.MethodsA nominated task force of dermatologists and immunologists who manage patients with severe urticaria formulated the consensus statements (CS) using the Delphi method. The consensus was defined a priori as an agreement of ≥80%.ResultsA total of 24 CS were formulated, including four statements on classifications and definitions, seven statements on diagnosis, and 13 statements on management and referral. The definitions for acute/chronic urticaria and severe CSU were stated. Unnecessary investigations and inappropriate medications were discouraged. The characteristics and recommended approach to suspected bradykinergic angioedema were specified. Stepwise treatment options using second-generation antihistamines, omalizumab, or cyclosporin for patients with CSU were addressed, and the importance of access to HAE-specific medications was emphasized. Furthermore, an integrated referral pathway for patients with severe hives and angioedema was constructed.ConclusionThe SHARP provides guidance for the management and specialist referral of patients with severe hives and angioedema in Hong Kong and Macau. |
| first_indexed | 2024-03-09T02:37:45Z |
| format | Article |
| id | doaj.art-a7ad1eadc48e41c887b28ee02eb93383 |
| institution | Directory Open Access Journal |
| issn | 2673-6101 |
| language | English |
| last_indexed | 2024-03-09T02:37:45Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Allergy |
| spelling | doaj.art-a7ad1eadc48e41c887b28ee02eb933832023-12-06T08:20:05ZengFrontiers Media S.A.Frontiers in Allergy2673-61012023-12-01410.3389/falgy.2023.12900211290021Hong Kong–Macau Severe Hives and Angioedema Referral PathwayPhilip H. Li0Elaine Y. L. Au1Si-Leong Cheong2Ling Chung3Ka I. Fan4Marco H. K. Ho5Agnes S. Y. Leung6Agnes S. Y. Leung7Martin M. H. Chung8Jane C. Y. Wong9Ricardo Coelho10Division of Rheumatology and Clinical Immunology, Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDivision of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong, Hong Kong SAR, ChinaDepartment of Dermatology, Centro Hospitalar Conde de São Januário, Macau, Macao SAR, ChinaDepartment of Dermatology, Centro Hospitalar Conde de São Januário, Macau, Macao SAR, ChinaDepartment of Dermatology, Centro Hospitalar Conde de São Januário, Macau, Macao SAR, ChinaLee Tak Hong Allergy Centre, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong SAR, ChinaDepartment of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaHong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDivision of Dermatology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, ChinaDivision of Rheumatology and Clinical Immunology, Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Dermatology, Centro Hospitalar Conde de São Januário, Macau, Macao SAR, ChinaBackgroundUrticaria (defined as the presence of hives, angioedema, or both) can be caused by a variety of etiologies ranging from more common conditions such as chronic spontaneous urticaria (CSU) to rarer conditions such as hereditary angioedema (HAE). Specialist referral may be necessary in cases of severe urticaria or HAE, but access to specialist services remains limited in certain regions, such as the Greater Bay Area (GBA) of China. To address this, the Hong Kong–Macau Severe Hives and Angioedema Referral Pathway (SHARP) was initiated by the Hong Kong Institute of Allergy and Macau Society of Dermatology to promote multidisciplinary collaboration and regional exchange of expertise in the diagnosis and management of severe urticaria.MethodsA nominated task force of dermatologists and immunologists who manage patients with severe urticaria formulated the consensus statements (CS) using the Delphi method. The consensus was defined a priori as an agreement of ≥80%.ResultsA total of 24 CS were formulated, including four statements on classifications and definitions, seven statements on diagnosis, and 13 statements on management and referral. The definitions for acute/chronic urticaria and severe CSU were stated. Unnecessary investigations and inappropriate medications were discouraged. The characteristics and recommended approach to suspected bradykinergic angioedema were specified. Stepwise treatment options using second-generation antihistamines, omalizumab, or cyclosporin for patients with CSU were addressed, and the importance of access to HAE-specific medications was emphasized. Furthermore, an integrated referral pathway for patients with severe hives and angioedema was constructed.ConclusionThe SHARP provides guidance for the management and specialist referral of patients with severe hives and angioedema in Hong Kong and Macau.https://www.frontiersin.org/articles/10.3389/falgy.2023.1290021/fullangioedemahereditaryhivesHong KongMacaureferral |
| spellingShingle | Philip H. Li Elaine Y. L. Au Si-Leong Cheong Ling Chung Ka I. Fan Marco H. K. Ho Agnes S. Y. Leung Agnes S. Y. Leung Martin M. H. Chung Jane C. Y. Wong Ricardo Coelho Hong Kong–Macau Severe Hives and Angioedema Referral Pathway Frontiers in Allergy angioedema hereditary hives Hong Kong Macau referral |
| title | Hong Kong–Macau Severe Hives and Angioedema Referral Pathway |
| title_full | Hong Kong–Macau Severe Hives and Angioedema Referral Pathway |
| title_fullStr | Hong Kong–Macau Severe Hives and Angioedema Referral Pathway |
| title_full_unstemmed | Hong Kong–Macau Severe Hives and Angioedema Referral Pathway |
| title_short | Hong Kong–Macau Severe Hives and Angioedema Referral Pathway |
| title_sort | hong kong macau severe hives and angioedema referral pathway |
| topic | angioedema hereditary hives Hong Kong Macau referral |
| url | https://www.frontiersin.org/articles/10.3389/falgy.2023.1290021/full |
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