title: Promising option in the prevention of idiopathic anaphylaxis: omalizumab.
abstract: Anaphylaxis is a serious and probably lethal systemic reaction which occurs instantaneously after exposure to an allergen. It can occur after exposure to various triggers including allergic and non-allergic factors. When a trigger cannot be determined, idiopathic anaphylaxis is considered. In idiopathic anaphylaxis presenting with frequent attacks, long-term prophylaxis with H(1) antihistamine and steroid treatment are recommended. Omalizumab, a humanized monoclonal antibody drug which decreases free immunoglobulin E molecules in the circulation, is approved for the treatment of chronic severe persistent allergic asthma. We report a 46-year-old female patient with severe uncontrolled allergic asthma and idiopathic anaphylaxis presenting with attacks of abdominal pain, generalized urticaria, feeling of strangulation in her throat and unconsciousness. Omalizumab at a dose of 375 mg once every 2 weeks was administrated and at the end of 3 months anaphylactic attacks had ceased. At the end of the sixth month of omalizumab therapy, her injection intervals were extended to 4 weeks. After she began experiencing moderate attacks of urticaria and hoarsening, however, initial treatment plan was reestablished. Currently, she has completed her first year of treatment without further attacks.
authors.affiliation: Department of Internal Medicine, Division of Allergy, Istanbul University, Istanbul, Turkey. mustafadt@yahoo.com
authors.forename: Mustafa
authors.initials: M
authors.lastname: Demirtürk
authors.forename: Asli
authors.initials: A
authors.lastname: Gelincik
authors.forename: Bahattin
authors.initials: B
authors.lastname: Colakoğlu
authors.forename: Murat
authors.initials: M
authors.lastname: Dal
authors.forename: Suna
authors.initials: S
authors.lastname: Büyüköztürk
mesh_terms: D000707:Anaphylaxis / Q000209:etiology / Q000517:prevention & control*; D018926:Anti-Allergic Agents / Q000008:administration & dosage; D000888:Antibodies, Anti-Idiotypic / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D001249:Asthma / Q000628:therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D000069444:Omalizumab; D014581:Urticaria / Q000517:prevention & control
chemical_list: D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab