title: [Omalizumab: therapeutic option in chronic spontaneous urticaria difficult to control with associated vasculitis, report of three cases].
abstract: BACKGROUND
  Approximately 50% of chronic urticaria cases do not respond adequately to conventional doses of antihistamines, so a number of other therapeutic options have been suggested. Among these, omalizumab is an innovative tool, which now has high-quality evidence that supports its use in difficult cases, rapidly improving the symptom index and the use of medications with a good safety profile.
  
  
  OBJECTIVE
  To report three cases of adult women with spontaneous chronic urticaria with an evolution of more than eight years, which did not improve with high doses of antihistamines and leukotriene receptor blockers, associated with immunomodulatory therapy in which several etiologic mechanisms were combined: chronic spontaneous urticaria with autoimmune and pressure components, and vasculitis.
  
  
  METHODS
  We report the cases with their clinical and laboratory evaluations, used medication, the response after the start of omalizumab and we performed a review of the literature on the use of this drug in chronic urticaria.
  
  
  RESULTS
  In all the presented cases, we obtained complete improvement of symptoms after starting omalizumab.
  
  
  CONCLUSIONS
  Omalizumab is a successful treatment option in cases of difficult to control chronic urticaria with associated vasculitis in which the options proposed by international guidelines have been exhausted.
authors.affiliation: Grupo de Alergología Clínica y Experimental (GACE), Universidad de Antioquia, Medellín, Colombia.
authors.forename: Libia Susana
authors.initials: LS
authors.lastname: Díez
authors.affiliation: Cátedra de Dermatología, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia.
authors.forename: Liliana María
authors.initials: LM
authors.lastname: Tamayo
authors.affiliation: Cátedra de Alergología Clínica, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cardona
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*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008875:Middle Aged; D000069444:Omalizumab; D014581:Urticaria / Q000150:complications* / Q000188:drug therapy*; D014657:Vasculitis / Q000150:complications*
chemical_list: D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab