case_images: PMC6768441_01
case_images: Mast cell tryptase (MCT) level with the progression of symptoms and events over a 5-year period. Despite current elevations of MCT >19.5 mug L-1 in June 2016, the patient remains symptom-free with maintenance 150 mg omalizumab monthly and ongoing maintenance BV-SCIT. ^Omalizumab induction regime 150 mg, two doses, 2 weeks apart. *Reduced doses of antihistamines required with the introduction of omalizumab. Cetirizine 30 mg daily reduced to 10 mg daily and fexofenadine 720 mg daily to 180 mg daily. Prednisolone 50 mg weaned to 5 mg and then ceased.
case_images: CTI2-8-e01075-g001.jpg
case_images: PMC6768441_01_CTI2-8-e01075-g001.jpg
case_images: cti21075-fig-0001
case_images: Baseline serum mast cell tryptase (MCT) was 19.2 mug L-1 (Figure 1; normal< 14.0 mug L-1) and serum immunoglobulin E 344 kU L-1 (normal < 111 kU L-1). He has been able to reduce his daily use of antihistamines to one tablet of fexofenadine (180 mg) in addition to 10 mg montelukast (Figure 1). Mast cell tryptase levels remain stable, albeit elevated (Figure 1).