case_images: PMC6652742_01
case_images: PMC6652742_02
case_images: Effect of immunoglobulin replacement therapy and omalizumab on clinical severity of chronic urticaria by UAS7 score. Ig, Immunoglobulin; IVIG, intravenous immunoglobulin.
case_images: fimmu-10-01700-g0001.jpg
case_images: PMC6652742_02_fimmu-10-01700-g0001.jpg
case_images: F1
case_images: Nevertheless, after 3 cycles of high-dose IVIG, the patient had a recurrence of severe CSU and thereafter continued to experience uncontrolled cutaneous symptoms for 2 years, despite being concomitantly treated with different combinations of second-generation H1-antihistamines up to 2- to 3-fold the approved doses together with an H2-antihistamine and/or a leukotriene receptor antagonist (Figure 1). At the age of 17.8 years old, considering the substantial impact of CSU on everyday quality of life with an UAS7 of 38, and the recurrent need for short courses of oral prednisone, an add-on treatment with omalizumab was started, 300 mg every 4 weeks, resulting in complete remission of urticaria symptoms within a week from the first injection, with no further need for controller medications (Figure 1). She was restarted on omalizumab, which led to an immediate resolution of skin lesions (Figure 1).