Successful off-label use of omalizumab in a child with chronic spontaneous urticaria

Abstract Omalizumab is approved as third-line therapy for patients older than 12 years with antihistamine-refractory chronic spontaneous urticaria. The authors present the case of an eight-year-old boy with a history of migratory maculopapular skin lesions, arthralgias, and conjunctival hyperemia. Laboratory findings were unremarkable. Skin biopsy was consistent with urticaria. Treatment with oral betamethasone and quadruple dose of bilastine was initiated, with clinical resolution of arthralgias and conjunctival hyperemia, but no improvement in skin lesions. After five months of illness, the patient developed several side effects of corticosteroids and was started on cyclosporine, with no clinical response after four weeks of treatment. At this point, he was started on off-label omalizumab 300 mg every four weeks, and corticosteroid therapy was discontinued after one month of treatment. After the third administration of omalizumab, the boy achieved complete clinical resolution. Omalizumab may be an effective and safe treatment for antihistamine-refractory chronic spontaneous urticaria in pediatric age.

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Main Authors: Gonçalves,Tânia, Coutinho,Iolanda Alen, Pita,Joana Sofia, Pinto,Paula Leiria
Format: Digital revista
Language:English
Published: Centro Hospitalar do Porto 2024
Online Access:http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-07542024000100051
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spelling oai:scielo:S0872-075420240001000512024-04-16Successful off-label use of omalizumab in a child with chronic spontaneous urticariaGonçalves,TâniaCoutinho,Iolanda AlenPita,Joana SofiaPinto,Paula Leiria chronic spontaneous urticaria omalizumab Pediatrics urticaria Abstract Omalizumab is approved as third-line therapy for patients older than 12 years with antihistamine-refractory chronic spontaneous urticaria. The authors present the case of an eight-year-old boy with a history of migratory maculopapular skin lesions, arthralgias, and conjunctival hyperemia. Laboratory findings were unremarkable. Skin biopsy was consistent with urticaria. Treatment with oral betamethasone and quadruple dose of bilastine was initiated, with clinical resolution of arthralgias and conjunctival hyperemia, but no improvement in skin lesions. After five months of illness, the patient developed several side effects of corticosteroids and was started on cyclosporine, with no clinical response after four weeks of treatment. At this point, he was started on off-label omalizumab 300 mg every four weeks, and corticosteroid therapy was discontinued after one month of treatment. After the third administration of omalizumab, the boy achieved complete clinical resolution. Omalizumab may be an effective and safe treatment for antihistamine-refractory chronic spontaneous urticaria in pediatric age.info:eu-repo/semantics/openAccessCentro Hospitalar do PortoNascer e Crescer v.33 n.1 20242024-03-01info:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-07542024000100051en10.25753/birthgrowthmj.v33.i1.28163b
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country Portugal
countrycode PT
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region Europa del Sur
libraryname SciELO
language English
format Digital
author Gonçalves,Tânia
Coutinho,Iolanda Alen
Pita,Joana Sofia
Pinto,Paula Leiria
spellingShingle Gonçalves,Tânia
Coutinho,Iolanda Alen
Pita,Joana Sofia
Pinto,Paula Leiria
Successful off-label use of omalizumab in a child with chronic spontaneous urticaria
author_facet Gonçalves,Tânia
Coutinho,Iolanda Alen
Pita,Joana Sofia
Pinto,Paula Leiria
author_sort Gonçalves,Tânia
title Successful off-label use of omalizumab in a child with chronic spontaneous urticaria
title_short Successful off-label use of omalizumab in a child with chronic spontaneous urticaria
title_full Successful off-label use of omalizumab in a child with chronic spontaneous urticaria
title_fullStr Successful off-label use of omalizumab in a child with chronic spontaneous urticaria
title_full_unstemmed Successful off-label use of omalizumab in a child with chronic spontaneous urticaria
title_sort successful off-label use of omalizumab in a child with chronic spontaneous urticaria
description Abstract Omalizumab is approved as third-line therapy for patients older than 12 years with antihistamine-refractory chronic spontaneous urticaria. The authors present the case of an eight-year-old boy with a history of migratory maculopapular skin lesions, arthralgias, and conjunctival hyperemia. Laboratory findings were unremarkable. Skin biopsy was consistent with urticaria. Treatment with oral betamethasone and quadruple dose of bilastine was initiated, with clinical resolution of arthralgias and conjunctival hyperemia, but no improvement in skin lesions. After five months of illness, the patient developed several side effects of corticosteroids and was started on cyclosporine, with no clinical response after four weeks of treatment. At this point, he was started on off-label omalizumab 300 mg every four weeks, and corticosteroid therapy was discontinued after one month of treatment. After the third administration of omalizumab, the boy achieved complete clinical resolution. Omalizumab may be an effective and safe treatment for antihistamine-refractory chronic spontaneous urticaria in pediatric age.
publisher Centro Hospitalar do Porto
publishDate 2024
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-07542024000100051
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AT coutinhoiolandaalen successfulofflabeluseofomalizumabinachildwithchronicspontaneousurticaria
AT pitajoanasofia successfulofflabeluseofomalizumabinachildwithchronicspontaneousurticaria
AT pintopaulaleiria successfulofflabeluseofomalizumabinachildwithchronicspontaneousurticaria
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