Brunetta Enrico, Shiffer Dana, Folci Marco, Achenza Maria I S, Puggioni Francesca, Heffler Enrico, Furlan Raffaello, Canonica Giorgio W
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Internal Medicine, Humanitas Research Hospital, Milan, Italy.
Case Reports Immunol. 2018 Jul 22;2018:8067610. doi: 10.1155/2018/8067610. eCollection 2018.
Presently, there is inconclusive evidence regarding the most effective treatment for idiopathic nonhistaminergic acquired angioedema (InH-AAE). Omalizumab may, however, prove to be a promising option. This case report describes two patients who presented with recurrent angioedema attacks, which was refractory to antihistamine therapy. Hence, they were treated with 300 mg omalizumab, every 4 weeks, for a period of 6 months. Both patients had shown a rapid response to the treatment and achieved complete resolution of symptoms without further AE attacks throughout the entire duration of the treatment period. After omalizumab's suspension, one patient remained symptom free for the following 6 months and the other patient had recurrence of symptoms after 2 months for which he was retreated with omalizumab and once again became symptom free. Although omalizumab seems to be effective as a prophylactic treatment for InH-AAE, the determining factors leading to the differences in time-to-relapse between patients after its suspension remain unclear. Further studies are needed in order to better determine the potential therapeutic application of omalizumab and its role in maintenance therapy.
目前，关于特发性非组胺能获得性血管性水肿（InH-AAE）的最有效治疗方法，证据尚无定论。然而，奥马珠单抗可能是一个有前景的选择。本病例报告描述了两名出现复发性血管性水肿发作的患者，这些发作对抗组胺治疗无效。因此，他们接受了每4周300毫克奥马珠单抗的治疗，为期6个月。两名患者对治疗均表现出快速反应，在整个治疗期间症状完全缓解，未再出现血管性水肿发作。在停用奥马珠单抗后，一名患者在接下来的6个月内无症状，另一名患者在2个月后症状复发，为此他再次接受奥马珠单抗治疗，再次恢复无症状状态。尽管奥马珠单抗似乎作为InH-AAE的预防性治疗有效，但在其停用后患者复发时间差异的决定因素仍不清楚。需要进一步研究以更好地确定奥马珠单抗的潜在治疗应用及其在维持治疗中的作用。
