Background and Objectives: Chronic spontaneous urticaria (CSU) significantly affects patients’ quality of life (QoL) and remains challenging to manage, particularly in under-researched regions. This study aimed to assess the clinical burden, disease control, and quality of life among patients with CSU in Kazakhstan and to identify predictors of severe disease activity. Materials and Methods: We conducted a cross-sectional study of 350 patients with CSU attending the Republican Allergy Center in Almaty between December 2024 and June 2025. Patients were classified based on the presence of co-existing chronic inducible urticaria (CIndU), angioedema, or both. Disease activity, control, and QoL were assessed using the Urticaria Activity Score over 7 days (UAS7), Urticaria Control Test (UCT), and Dermatology Life Quality Index (DLQI), respectively. Multivariable logistic regression and correlation analyses were used to identify predictors of severe disease and interrelationships among clinical measures. Results: Among 350 patients (mean age 43.5 ± 14.7 years; 78% female), 46.3% had CSU alone, while 53.7% had associated phenotypes. Severe urticaria (UAS7 ≥ 28) affected 30% of patients. Suboptimal disease control (UCT ≤ 11) was reported in 30%, and 30% experienced strong or very strong QoL impairment (DLQI > 10). Older disease onset (≥60 years; OR = 1.98; 95% CI: 1.02–3.81) and nighttime symptoms (OR = 1.67; 95% CI: 1.02–2.73) were independently associated with severe disease. A strong inverse correlation was observed between UAS7 and UCT (ρ = −0.71), and a positive correlation between UAS7 and DLQI (ρ = 0.66), highlighting the impact of disease activity on control and QoL. Conclusions: CSU imposes a substantial clinical and psychosocial burden in Kazakhstan. One-third of patients experience severe symptoms and impaired QoL despite ongoing treatment. Older age at disease onset and nighttime symptoms may serve as practical indicators of disease severity. These findings highlight the need for improved access to advanced therapies, systematic monitoring using validated tools, and multidisciplinary care strategies in resource-constrained settings.

This study revealed primary immunodeficiency developing as a result of a genetically mediated quantitative deficiency or a decrease in the activity of the C1 component complement inhibitor in a family clinical case of patients with genetically confirmed hereditary angioedema, who were living in Taldykorgan, Almaty, Republic of Kazakhstan. Anamnesis data and clinical and laboratory-instrumental indicators were evaluated. In addition to assessing the objective status and general clinical laboratory studies, all patients underwent studies to determine the quantitative content of C4 and C1 inhibitor of the complement component and the presence of a mutation in the SERPING1 gene. The polymorphism of clinical and anamnestic data did not allow timely identification of specific syndromes and determination of a clinical diagnosis. As a result, specific basic treatment, preventive measures, and preventive intervention associated with traumatic life and medical situations were given late, leading to life-threatening conditions. The main clinical manifestations of hereditary angioedema are recurrent dense edema, lasting 25 days. The skin, upper respiratory tract, and gastrointestinal tract are the organs most involved. Clinical manifestations in patients vary dramatically, from the absence of characteristic symptoms to life-threatening edema, leading to death.