Details

Autor(en) / Beteiligte

• Heffler, Enrico, MD, PhD
• Fichera, Silvia, MD
• Nicolosi, Giuliana, MD
• Crimi, Nunzio, MD, PhD

Titel

Anaphylaxis due to progesterone hypersensitivity successfully treated with omalizumab

Ist Teil von

• The journal of allergy and clinical immunology in practice (Cambridge, MA), 2017-05, Vol.5 (3), p.852-854

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• 2,5 The therapeutic options for this clinical entity, apart from intramuscular epinephrine for the acute treatment of each episode, include high-dose systemic steroids, hormone-targeted therapies (such as gonadotropin-releasing hormone agonists or estrogen-suppressive therapy such as selective estrogen-receptor modulators or aromatase inhibitors), progesterone desensitization, or surgical salpingo-oophorectomy.6 A 12-year-old girl (menarche at age 11 years and 3 months) without any history of allergic signs or symptoms presented to our Allergy Outpatient Clinic for a recent (10 days before, 1-3 days before the onset of menses, and a few hours after the intake of paracetamol 1000 mg for menstrual cramps) episode of acute diffuse urticaria associated with labial and eyelid angioedema. Autoinjectable epinephrine was immediately prescribed, and the patient was instructed on its indications and on how to use it in case of a new episode of anaphylaxis. Because the allergological visit was just 3 days before the next expected menses, treatment with prednisone 25 mg/d plus cetirizine 10 mg/d was prescribed until 3 days after the beginning of menses (6 days treatment in total). Omalizumab, apart from the 2 primary and US Food and Drug Administration-approved indications (severe allergic asthma and severe chronic spontaneous urticaria), has been described to be effective in several other allergic conditions, such as in reducing the risk of anaphylaxis due to allergy immunotherapy7 and in vernal keratoconjunctivitis.9 The precise mechanisms of action of omalizumab, particularly in chronic spontaneous urticaria and in the nonconventional indications, is still not completely clarified. References 1 N. Fenny, L.C. Grammer, Idiopathic...