Successful Treatment of Hypocomplementemic Urticarial Vasculitis With Omalizumab: A Case Report
Abstract
J Investig Allergol Clin Immunol 2020; Vol. 30(3): 191-214 © 2020 Esmon Publicidad It should also be noted that the patient did not develop major organ involvement at any time. Initially, the patient was treated with prednisone (60 mg/d), although she experienced new flares of erythematousedematous lesions when the dose was reduced to below 10 mg/d. Levocetirizine was used as an antihistamine. Since she had elevated intraocular pressure, hydroxyzine was contraindicated by her ophthalmologists due to its anticholinergic effect. She continued treatment with prednisone (10-15 mg/d), which was subsequently combined with azathioprine (150 mg/d) and dapsone (100 mg/d). Despite treatment with these drugs, the pruritic maculopapular lesions persisted and were subsequently treated with intramuscular corticosteroids. The patient also began to experience severe corticosteroid-induced adverse effects such as polymyalgia, corticosteroid-induced diabetes (with hospital emergency care for secondary hyperosmolar syndrome), weight gain (20 kg) with cushingoid appearance, and increased intraocular pressure. Given the poor response to corticosteroids and immunosuppressants, we requested off-label treatment with omalizumab. After we received authorization, the patient started with 300 mg every 4 weeks in 2015. Azathioprine (150 mg/d) and prednisone (10-15 mg/d) were maintained until the skin lesions improved. Both treatments were discontinued after 7 months without symptoms. Five months later,…
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