Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano, Italy.
School of Medicine, Università Vita Salute San Raffaele, Milano, Italy.
Front Immunol. 2022 Apr 12;13:853561. doi: 10.3389/fimmu.2022.853561. eCollection 2022.
Chronic urticaria (CU) is defined by the presence of itchy wheals, sometimes accompanied by angioedema, lasting for at least 6 weeks. CU is treated with second-generation antihistamines, increased up to four times the normal doses for second-line treatment. Omalizumab (a monoclonal antibody anti-IgE) may be recommended as third-line therapy in children aged over 12 years. Few reports have suggested that glucose homeostasis is impaired in some type 2 diabetic patients receiving omalizumab, and even in non-diabetic patients, fasting blood glucose and HOMA-IR values appeared to be significantly increased. We report the case of a 13-year-old girl with diabetes mellitus type 1 and chronic spontaneous urticaria (CSU) refractory to standard recommended therapy that we treated with omalizumab at a standard recommended dose of 300 mg every 4 weeks. We observed a rapid and complete remission of CSU after treatment with this humanized monoclonal antibody without detrimental effects on the patient's glucose control especially in terms of HbA1c (glycated hemoglobin), time in glycemic range (TIR), and daily insulin needs.
慢性荨麻疹（CU）的定义为瘙痒性风团的存在，有时伴有血管性水肿，持续至少 6 周。CU 采用第二代抗组胺药治疗，增加至正常剂量的四倍作为二线治疗。奥马珠单抗（一种抗 IgE 的单克隆抗体）可作为 12 岁以上儿童的三线治疗药物。一些报告表明，一些 2 型糖尿病患者在接受奥马珠单抗治疗时，糖稳态受损，即使在非糖尿病患者中，空腹血糖和 HOMA-IR 值似乎也明显升高。我们报告了一例 13 岁的 1 型糖尿病合并慢性自发性荨麻疹（CSU）的病例，该患者对标准推荐的治疗方法无反应，我们以每 4 周 300mg 的标准推荐剂量用奥马珠单抗治疗。我们观察到，在使用这种人源化单克隆抗体治疗后，CSU 迅速完全缓解，对患者的血糖控制没有不利影响，特别是在糖化血红蛋白（HbA1c）、血糖达标时间（TIR）和每日胰岛素需求方面。
