Experience with anti – IgE – therapy in children with chronic inducible urticaria: clinical cases.

2021 ◽  
Author(s):  
Inna Larkova
Keyword(s):  
Clinical Manifestations ◽  
Chronic Spontaneous Urticaria ◽  
Off Label ◽  
Chronic Inducible Urticaria ◽  
Inducible Urticaria ◽  
Clinical Cases

Abstract. Introduction: in children with chronic inducible urticaria, anti-IgE therapy is possible when combined with chronic spontaneous urticaria, otherwise the treatment is considered "off label", since there are no approved recommendations for this category of patients due to insufficient research on the effectiveness, prescription and duration of such treatment Conclusion: Based on clinical cases, the authors present there own experience of successful anti-IgE- therapy of various clinical manifestations of chronic inducible urticaria in children.

scholarly journals Chronic Spontaneous Urticaria: A Review of Pathological Mechanisms, Diagnosis, Clinical Management, and Treatment

2020 ◽  
pp. 29-39
Author(s):  
Victor Desmond Mandel ◽  
Tatiana Alicandro ◽  
Patrizia Pepe ◽  
Laura Bonzano ◽  
Mario Bruno Guanti ◽  
...  
Keyword(s):  
Clinical Management ◽  
Metabolic Diseases ◽  
Clinical Manifestations ◽  
Sun Exposure ◽  
Sudden Onset ◽  
Chronic Spontaneous Urticaria ◽  
Biological Drugs ◽  
Chronic Inducible Urticaria ◽  
Inducible Urticaria ◽  
New Generation

Urticaria is a poorly understood and underestimated clinical condition characterised by the sudden onset of itchy wheals and/or angioedema, which usually resolve within 24 and 72 hours, respectively. It is generally classified as being acute (lasting <6 weeks) or chronic (continuous or intermittent for ≥6 weeks). Chronic urticaria can be further classified as chronic spontaneous urticaria (CSU) and chronic inducible urticaria, appearing in response to specific eliciting factors, such as heat, cold, or sun exposure, or following the application of pressure. Scientific advances have been made in the understanding of pathological mechanisms and treatment, especially associated with CSU. The exact pathological mechanism of how urticaria develops is still not yet fully understood, but the clinical implications on the patients’ quality of life are severe and have been associated with mental disorders and metabolic diseases. The diagnosis of urticaria is based on medical history and clinical manifestations. The treatment pathway begins with the administration of second-generation, nonsedating, nonimpairing histamine 1 receptor antihistamines and, in case of nonresponse, with new-generation biological drugs. The current review presents an update of the pathological mechanisms, diagnosis, clinical management, and treatment of CSU. It also focusses on the future implications of new-generation drugs and their effects on the clinical practice.

scholarly journals Cholinergic urticaria: novel aspects of pathogenesis, diagnosis and management

2021 ◽  
Vol 24 (3) ◽  
pp. 211-226
Author(s):  
Elena Yu. Borzova ◽  
Christina Yu. Popova ◽  
Marcin Kurowski ◽  
Maia T. Rukhadze ◽  
Razvigor Darlenski ◽  
...  
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Main Research ◽  
Cholinergic Urticaria ◽  
Chronic Inducible Urticaria ◽  
H1 Antihistamines ◽  
Inducible Urticaria ◽  
Diagnostic Approaches ◽  
Challenge Tests ◽  
Pathophysiologic Mechanisms

Cholinergic urticaria (CholU) is a chronic inducible urticaria, characterised by itchy pinpoint wheals up to 3 mm in diameter, surrounded by a prominent flare, that occur following an exposure to characteristic triggers such as active or passive heating, physical exercise, emotions, hot or spicy foods. Key pathophysiologic mechanisms include immediate hypersensitivity to autologous sweat antigens, functional sweating disorders, impaired acethylcholine metabolism, abnormal skin vascular permeability and disturbed skin innervation. Clinical manifestations of CholU may vary from typical itchy pinpoint urticarial lesions, angioedema to anaphylaxis. Atypical CholU forms include cholinergic pruritus, cholinergic dermographism, cold cholinergic urticaria and persistent cholinergic erythema. The diagnosis of cholinergic urticaria relies on patients history, сlinical manifestations and challenge tests. Treatment options include nonsedating H1 antihistamines in standard or increased doses. The evidence is accumulating for the use of biological treatment with omalizumab in cholinergic urticaria. The prospect of personalized treatment of cholinergic urticaria include autologous sweat desensitization. The main research efforts in ColdU are directed at optimizing diagnostic approaches and developing innovative therapeutic options.

Modern anti-IgE therapies in children with chronic spontaneous urticaria: clinical cases

2021 ◽  
Vol 17 (4) ◽  
pp. 85-89
Author(s):  
Inna A. Larkova ◽  
Vera A. Revyakina
Keyword(s):  
Chronic Urticaria ◽  
Clinical Manifestations ◽  
Chronic Spontaneous Urticaria ◽  
First Line ◽  
Therapy Efficacy ◽  
Number Of Patients ◽  
H1 Antihistamines ◽  
Urticaria Treatment ◽  
Clinical Cases

The diagnostics and treatment of chronic urticaria is still a pressing problem for specialists of different profiles. Despite the fact that the first line drugs for urticaria treatment are non-sedating H1- antihistamines, there are a number of patients who do not respond to these medications even in their increased doses. This article presents clinical cases of anti-IgE-therapy efficacy in children suffering from urticaria and angioedema. CONCLUSION: The clinical cases demonstrate current possibilities of successful and safe anti-IgE-therapy of various clinical manifestations of chronic spontaneous urticaria and angioedema in children.

scholarly journals Chronic Spontaneous Urticaria – Diagnosis and Management

2021 ◽  
Author(s):  
Evmorfia Ladoyanni
Keyword(s):  
Chronic Urticaria ◽  
Psychological Factors ◽  
Immunoglobulin E ◽  
Immunoglobulin A ◽  
Life Quality ◽  
Chronic Spontaneous Urticaria ◽  
Specific Stimulus ◽  
Chronic Inducible Urticaria ◽  
Number Of Patients ◽  
Inducible Urticaria

Chronic urticaria can be subclassified into chronic spontaneous urticaria and chronic inducible urticaria. Up to 30% of cases are associated with functional immunoglobulin G antibodies to the high affinity immunoglobulin E receptor FcεRIα or to immunoglobulin A. Pathogenic activation of mast cells and basophils gives rise to release of pro-inflammatory mediators that lead to development of hives. CSU is a debilitating disease with a relapsing course. It affects 0.5–1% of the population at any given time. The duration of CSU is generally 1–5 years but can be longer in cases associated with angioedema and autoreactivity. CSU has detrimental effects on life quality with sleep-deprivation and psychiatric disorders being the most frequent. In a great number of patients an underlying cause or eliciting factor cannot be identified. Among the patients in which an aetiology is suspected, infections, medication, food and psychological factors are most commonly associated. A potential autoimmune cause has been reported in up to 50% of patients. Chronic inducible urticaria is characterised by its ability to be triggered consistently and reproducibly in response to a specific stimulus (pressure, temperature, vibration, water, heat, light). Antihistamines form the mainstay of therapy. In recalcitrant chronic urticaria, a variety of other drugs have been tried.

scholarly journals Russian experience of refractory chronic urticaria treatment with omalizumab

2015 ◽  
Vol 12 (3) ◽  
pp. 16-21
Author(s):  
I V Danilycheva ◽  
O G Elisyutina ◽  
N I Ilina ◽  
E A Latysheva ◽  
T V Latysheva ◽  
...  
Keyword(s):  
Chronic Urticaria ◽  
Marked Effect ◽  
Clinical Analysis ◽  
Chronic Spontaneous Urticaria ◽  
Efficacy And Safety ◽  
Chronic Inducible Urticaria ◽  
Inducible Urticaria ◽  
Urticaria Treatment ◽  
Practice Methods ◽  
Dose Change

Background. To study the efficacy and safety of omalizumab in patients with chronic urticaria, refractory to antihistamines in clinical practice. Methods. In this retrospective clinical analysis, we assessed effectiveness, time to relief of symptoms, dose change after omalizumab administration, and safety in 17 CU patients, 16 with chronic spontaneous urticaria (CSU), 1 with different forms of chronic inducible urticaria (CindU) and 4 with both. Results. Treatment with omalizumab showed excellent effect in 70,6%, significant - in 17,7%, no effect - in 11,7% of CU patients. Eight patients marked effect for 24 hours, 2 - within 2-3 days, 2 - during 2 weeks, 1 - 4 weeks, and 2 patients - for 8 weeks. Eleven patients were receiving omalizumab 300 mg once per 4 weeks, one patient - 150 mg, 4 patients 2 injections of 300 mg, followed by 150 mg of 2, one patient had started treatment with a dose of 150 mg, continued treatment with omalizumab 300 mg. Omalizumab was safe. There was no influence of baseline total IgE levels and the results of test with autosera on the efficacy of omalizumab treatment. Conclusion. Our observation of patients with chronic spontaneous urticaria, with the concomitant or separate physical (induced) hives can resume high efficacy and safety of omalizumab treatment which can be recommended for CU patients, torpid to the first and secondline therapy.

Effectiveness and tolerability of personalized omalizumab treatment in patients with chronic inducible urticaria

2021 ◽  
Author(s):  
Thomas P. Buters ◽  
Willemijn A.C. van der Velden ◽  
Ismahaan Abdisalaam ◽  
Maurits S. van Maaren ◽  
Martijn B.A. van Doorn
Keyword(s):  
Chronic Inducible Urticaria ◽  
Inducible Urticaria

scholarly journals Urticaria is not a sentence. The clinical cases

2016 ◽  
Vol 13 (2) ◽  
pp. 23-26
Author(s):  
I V Danilycheva ◽  
A E Shulzhenko ◽  
N G Bondarenko
Keyword(s):  
Effective Treatment ◽  
Therapeutic Antibody ◽  
Chronic Spontaneous Urticaria ◽  
Receptor Antagonists ◽  
Long Period ◽  
Leukotriene Receptor Antagonists ◽  
H1 Antihistamines ◽  
Leukotriene Receptor ◽  
Clinical Cases

Omalizumab - monoclonal therapeutic antibody to human IgE, is effectively used for the treatment of patients with chronic spontaneous urticaria (HSC), refractory to 4 times increased doses of antihistamines. The article describes two cases of effective treatment of patients (HSC) with omalizumab (Xolair® «Novartis Pharma» LLC) after a long period of unsuccessful therapy with H1-antihistamines, leukotriene receptor antagonists, and corticosteroids.

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