Administration of anti-IgE to a Churg-Strauss syndrome patient.
BACKGROUND
Treatment of the Churg-Strauss syndrome (CCS) remains a challenge. Many patients relapse after achieving remission, and a substantial proportion of them present adverse drug reactions with relevant morbidity. In most patients, severe asthma and upper respiratory symptoms persist, requiring continuous therapy. The aim of the present study is to describe a patient with CSS who was administered anti-IgE.


METHODS
A 46-year-old male patient with CSS followed up for 17 years is described. Upon treatment, CSS showed remission but asthma failed to improve despite high-dose inhaled corticosteroids, long-acting beta2-agonists and several courses of systemic steroids. In order to better control asthma, anti-IgE was administered. Following omalizumab administration, asthma symptoms (according to clinical features and lung function tests) and eosinophilia improved.


CONCLUSIONS
Anti-IgE offers the potential not only to decrease asthma activity but also to reduce the risk of morbidity that can result from currently available treatment options. Whether it can also affect the activity of other CSS components is an open question. As far as we know, there are no published reports about the prescription of omalizumab to patients with CSS and with non-allergic asthma. Anti-IgE improved our patient's asthma and decreased the eosinophil blood count but did not worsen the outcome of CSS. However, large and long-term studies are necessary before a more widespread utilization of anti-IgE in CSS patients can be implemented.
Giavina-Bianchi
Pedro
P
Division of Clinical Immunology and Allergy, University of São Paulo, São Paulo, Brazil. saudesos@saudesos.com.br
Giavina-Bianchi
Mara
M
Agondi
Rosana
R
Kalil
Jorge
J
D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D015267:Churg-Strauss Syndrome / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab; D016896:Treatment Outcome
D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C026408:anti-IgE antibodies; D000069444:Omalizumab