The Role of Corticosteroid Therapy in Schnitzler Syndrome: A Case Report
Abstract
Background: Urticaria is a common inflammatory mucocutaneous syndrome with multiple etiologies. When recalcitrant to standard antihistamine therapy, a systematic diagnostic workup is essential to identify rare underlying systemic conditions such as Schnitzler Syndrome. Case Presentation: We report the case of a 41-year-old woman with a background of chronic asthma, fibromyalgia, degenerative retinopathy, and nasal polyposis, who presented with an 8-month history of recalcitrant urticarial eruption. Despite sequential trials of multiple antihistamine regimens including cetirizine, hydroxyzine, loratadine, levocetirizine, desloratadine, montelukast, and bilastine at standard and quadruple doses no clinical improvement was observed. Extensive etiological workup excluded common chronic urticaria, drug-induced, infectious, inducible, and autoimmune causes, as well as urticarial vasculitis, Adult-onset Still's disease, systemic lupus erythematosus, and Cryopyrin-Associated Periodic Syndromes (CAPS). Serum protein electrophoresis revealed a monoclonal peak in the gamma-globulin zone, confirmed by immunofixation as monoclonal IgG elevation, establishing the diagnosis of Schnitzler Syndrome. Treatment and Outcome: The patient was initiated on corticosteroid therapy with prednisolone 40 mg/day for 3 months, resulting in marked clinical improvement. Conclusion: This case highlights the importance of a thorough diagnostic approach in chronic recalcitrant urticaria. While antihistamines…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Artificial Intelligence in Medicine: Cross-Sectional Study Among Medical Students on Application, Education, and Ethical Aspects
- Information quality of videos related to esophageal cancer on tiktok, kwai, and bilibili: a cross-sectional study
- The quality and reliability of short videos about hypertension on TikTok: a cross-sectional study
- Quality and reliability evaluation of pancreatic cancer-related video content on social short video platforms: a cross-sectional study
- Quality and reliability of pediatric pneumonia related short videos on mainstream platforms: cross-sectional study
- Association between metabolic score for insulin resistance (METS-IR) and hypertension: a cross-sectional study based on NHANES 2007–2018
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.