Case Report: Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Crohn’s Disease
Chronic spontaneous urticaria (CSU) is a mast cell-driven disease that is often associated with autoimmune or autoinflammatory conditions. Omalizumab is recommended in the treatment of refractory CSU in patients over 12 years of age who do not respond to four standard doses of antihistamines. Omaliz...
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doaj-b06cee7762064a3cb69ee473b2378e162021-03-02T12:40:40ZengFrontiers Media S.A.Frontiers in Immunology1664-32242021-03-011210.3389/fimmu.2021.635069635069Case Report: Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Crohn’s DiseaseSimona Barni0Mattia Giovannini1Giulia Liccioli2Lucrezia Sarti3Anna Gissi4Paolo Lionetti5Francesca Mori6Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, Florence, ItalyAllergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, Florence, ItalyAllergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, Florence, ItalyAllergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, Florence, ItalyGastroenterology and Nutrition Unit, Meyer Children’s University Hospital, Florence, ItalyGastroenterology and Nutrition Unit, Meyer Children’s University Hospital, Florence, ItalyAllergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, Florence, ItalyChronic spontaneous urticaria (CSU) is a mast cell-driven disease that is often associated with autoimmune or autoinflammatory conditions. Omalizumab is recommended in the treatment of refractory CSU in patients over 12 years of age who do not respond to four standard doses of antihistamines. Omalizumab blocks the mast cells’ degranulation, thus interrupting the resulting inflammatory cascade driven by T-helper 2 (Th2) cytokines. The efficacy of omalizumab in controlling CSU and possible associated diseases has been studied in few patients so far. In particular, some case reports describe adults with CSU and concomitant inflammatory bowel diseases (IBD), such as Crohn’s disease (CD) or ulcerative colitis (UC). Although the treatment of CD with anti-tumor necrosis factors-α (TNF-α) seems to be effective in controlling CSU, no cases of the utility of omalizumab in patients with both conditions have been described so far. At the moment, there is no evidence that the pathogenetic mechanisms underlying CD are linked to the same pathways that are inhibited by omalizumab for the treatment of CSU. We present the first pediatric case of refractory CSU and CD in which omalizumab led to CSU remission, even if the follow-up period was limited. In conclusion, our experience shows how CSU could be associated with CD and successfully treated with the monoclonal anti-IgE antibody in a patient on immunosuppressive therapy. However, more data is needed from a larger population.https://www.frontiersin.org/articles/10.3389/fimmu.2021.635069/fullanti-IgE monoclonal antibodychronic spontaneous urticariainflammatory bowel diseasesCrohn’s diseaseomalizumabadolescent |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Simona Barni Mattia Giovannini Giulia Liccioli Lucrezia Sarti Anna Gissi Paolo Lionetti Francesca Mori |
spellingShingle |
Simona Barni Mattia Giovannini Giulia Liccioli Lucrezia Sarti Anna Gissi Paolo Lionetti Francesca Mori Case Report: Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Crohn’s Disease Frontiers in Immunology anti-IgE monoclonal antibody chronic spontaneous urticaria inflammatory bowel diseases Crohn’s disease omalizumab adolescent |
author_facet |
Simona Barni Mattia Giovannini Giulia Liccioli Lucrezia Sarti Anna Gissi Paolo Lionetti Francesca Mori |
author_sort |
Simona Barni |
title |
Case Report: Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Crohn’s Disease |
title_short |
Case Report: Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Crohn’s Disease |
title_full |
Case Report: Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Crohn’s Disease |
title_fullStr |
Case Report: Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Crohn’s Disease |
title_full_unstemmed |
Case Report: Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Crohn’s Disease |
title_sort |
case report: refractory chronic spontaneous urticaria treated with omalizumab in an adolescent with crohn’s disease |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Immunology |
issn |
1664-3224 |
publishDate |
2021-03-01 |
description |
Chronic spontaneous urticaria (CSU) is a mast cell-driven disease that is often associated with autoimmune or autoinflammatory conditions. Omalizumab is recommended in the treatment of refractory CSU in patients over 12 years of age who do not respond to four standard doses of antihistamines. Omalizumab blocks the mast cells’ degranulation, thus interrupting the resulting inflammatory cascade driven by T-helper 2 (Th2) cytokines. The efficacy of omalizumab in controlling CSU and possible associated diseases has been studied in few patients so far. In particular, some case reports describe adults with CSU and concomitant inflammatory bowel diseases (IBD), such as Crohn’s disease (CD) or ulcerative colitis (UC). Although the treatment of CD with anti-tumor necrosis factors-α (TNF-α) seems to be effective in controlling CSU, no cases of the utility of omalizumab in patients with both conditions have been described so far. At the moment, there is no evidence that the pathogenetic mechanisms underlying CD are linked to the same pathways that are inhibited by omalizumab for the treatment of CSU. We present the first pediatric case of refractory CSU and CD in which omalizumab led to CSU remission, even if the follow-up period was limited. In conclusion, our experience shows how CSU could be associated with CD and successfully treated with the monoclonal anti-IgE antibody in a patient on immunosuppressive therapy. However, more data is needed from a larger population. |
topic |
anti-IgE monoclonal antibody chronic spontaneous urticaria inflammatory bowel diseases Crohn’s disease omalizumab adolescent |
url |
https://www.frontiersin.org/articles/10.3389/fimmu.2021.635069/full |
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