title: [A case of severe asthma and peach allergy that improved with omalizumab therapy: a case report].
abstract: A 30-year-old woman had refractory asthma. She had also experienced twice severe anaphylaxis episodes after ingesting peaches. The patient was extremely wary about reoccurrence of anaphylaxis and avoided ingesting any fruits, including peaches. She visited our hospital for testing and treatment for asthma and the peach allergy. Skin and serologic testing showed that she had a severe allergy to house dust, mites, and peaches. The food challenge test results showed that ingesting 6.5 g of the peach fruit induced dyspnea in the patient. Her asthma could not be controlled despite treatment involving a leukotriene receptor antagonist and combination inhalation of high-dose salmeterol xinafoate/fluticasone propionate. We advised the patient to keep strict avoidance ingesting peaches because of her food allergy. However, she hoped to overcome her food restrictions, especially those for fruits. We initiated treatment involving the recombinant humanized monoclonal anti-IgE antibody omalizumab (150 mg, once a month) to ensure that the asthma was controlled well and to improve the patient's diet. The asthmatic symptoms ameliorated, and the peak expiratory flow increased in a short time. We gradually reduced the restriction on peach consumption. This was achieved by rechallenging the patient with increasing doses of 290 mg of the peach fruit and was initiated at 28 weeks after starting omalizumab therapy. The restriction on peach consumption was lifted eventually, and the patient did not experience any allergic symptoms subsequently on ingesting peaches. Thus, for our patient, omalizumab therapy was highly effective in achieving remission from both asthma and peach allergy.
authors.affiliation: Department of Internal Medicine, Asoka Hosipital, Japan. szshintr@yahoo.co.jp
authors.forename: Shintaro
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsuura
authors.forename: Teruaki
authors.initials: T
authors.lastname: Kimura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Tazaki
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Fukuda
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Homma
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsukura
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Kurokawa
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Adachi
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000628:therapy; D003888:Desensitization, Immunologic; D005260:Female; D005512:Food Hypersensitivity / Q000188:drug therapy* / Q000628:therapy; D006801:Humans; D000069444:Omalizumab; D027861:Prunus / Q000009:adverse effects*
chemical_list: D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab