Failure of omalizumab and successful control with ketotifen in a patient with vibratory angio-oedema.
Vibratory angio-oedema is a rare form of physical urticaria characterized by pruriginous weals and angio-oedema at the site of exposure to vibration. Severe treatment-resistant disease can occur, and is associated with significant disability. Therapy with omalizumab, a monoclonal IgG anti-IgE antibody, has been shown to be successful in several types of physical urticaria. We report a patient with vibratory angio-oedema for whom all standard treatments for urticaria, including omalizumab, failed to show a clinical benefit. Finally, ketotifen was tried, and unexpectedly reduced symptoms significantly. Ketotifen may thus represent a therapeutic option in patients with treatment-resistant vibratory angio-oedema.
Department of Prevention and Sports Medicine, Technische Universität München, Munich, Germany.
A
A
Pressler
M
M
Grosber
M
M
Halle
J
J
Ring
K
K
Brockow
D000328:Adult; D000799:Angioedema / Q000188:drug therapy*; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000151:congenital* / Q000188:drug therapy; D007665:Ketotifen / Q000627:therapeutic use*; D000069444:Omalizumab; D016896:Treatment Outcome; D000094482:Chronic Inducible Urticaria
D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D006634:Histamine H1 Antagonists; D000069444:Omalizumab; D007665:Ketotifen