University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Int Arch Allergy Immunol. 2024;185(8):761-766. doi: 10.1159/000538046. Epub 2024 Mar 25.
In 15-35 percent of patients with anaphylaxis, the triggering allergen cannot be found; therefore, a diagnosis of idiopathic anaphylaxis (IA) is made. We report on the outcomes in patients with IA treated with omalizumab.
We included consequent omalizumab-treated IA adult patients treated with omalizumab 300 mg every 4 weeks.
Out of 7 patients, 6 were female, median age 40 years with the frequency of anaphylaxis episodes from 3 in 2 years to 5 in 4 months. Baseline tryptase ranged from 1.71 to 12.0 μg/L. An increase in tryptase during anaphylaxis was documented in 6 patients. Activating KIT p.D816V variant was detected in 2 patients. One patient also had hereditary alpha-tryptasemia (HαT). The duration of omalizumab treatment was 0.5-7.5 years. None of the patients have experienced an anaphylactic reaction since the start of treatment. Mild systemic reactions were reported in 6 patients (86%). The presence of underlying cMCD had no impact on the treatment outcome.
All patients in our study had complete responses to omalizumab. The presence of KIT p.D816V and HαT did not influence the response to omalizumab treatment.
在 15-35%的过敏反应患者中，无法找到触发过敏原；因此，诊断为特发性过敏反应（IA）。我们报告了接受奥马珠单抗治疗的特发性过敏反应患者的结局。
我们纳入了连续接受奥马珠单抗治疗的特发性过敏反应成年患者，接受奥马珠单抗 300mg，每 4 周一次。
7 例患者中，6 例为女性，中位年龄 40 岁，过敏反应发作频率从 2 年内 3 次到 4 个月内 5 次不等。基线类胰蛋白酶范围为 1.71-12.0μg/L。6 例患者的过敏反应期间类胰蛋白酶升高。2 例患者检测到激活 KIT p.D816V 变异。1 例患者还患有遗传性α-胰蛋白酶血症（HαT）。奥马珠单抗治疗的持续时间为 0.5-7.5 年。自治疗开始以来，没有患者发生过敏反应。6 例患者（86%）报告有轻度全身反应。潜在的 cMCD 存在对治疗结果没有影响。
我们研究中的所有患者对奥马珠单抗均有完全反应。KIT p.D816V 和 HαT 的存在并不影响奥马珠单抗治疗的反应。
