A CASE OF SEVERE ASTHMA RESPONSIVE TO OMALIZUMAB TREATMENT DESPITE A LOW SERUM IGE LEVEL AND LACK OF SENSITIZED ALLERGENS

Sugino Yasuteru, Sanda Ryo, Takagi Yasuyuki, Kato Motoaki, Ohta Akiko, Okumura Junya, Nagai Hideaki

doi:10.15036/arerugi.59.1572

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Other Title

血清IgE低値でアレルゲンが明瞭でない重症喘息にオマリズマブが奏効した1例
症例報告血清IgE低値でアレルゲンが明瞭でない重症喘息にオマリズマブが奏効した1例
ショウレイホウコクケッセイ IgE テイチデアレルゲンガメイリョウデナイジュウショウゼンソクニオマリズマブガソウコウシタ 1レイ

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Abstract

A 49-year-old female patient suffering from severe intractable asthma uncontrolled even with high-dose inhaled glucocorticosteroids (fluticasone 1000μg/day+ciclesonide 800μg/day), salmeterol inhaler (100μg/day) and oral betamethasone (1mg/day) was admitted to our hospital because of severe asthma attack. The total serum IgE level was low at 9 (IU/mL). Though perennial allergens was also negative, administration of 150mg omalizumab was started in August 2009 with the patient's consent, resulting in noticeable improvements in asthma symptoms and the peak expiratory flow (PEF) were achieved. Due to her weight gain and general malaise, the drug was discontinued after the second administration, resulting in worsening of asthma symptoms. Omalizumab therapy was restarted in January 2010 and marked improvements in asthma symptoms and PEF were noted. The effects continued for approximately three weeks after administration. After the sixth administration, the dose of oral betamethasone successfully reduced to 0.5mg/day. When comparing the six-month preand post-omalizumab therapy period, asthma-related events such as unscheduled hospital visits were also reduced, and the dose of oral betamethasone could also be reduced to 64% of the pretherapy period after the omalizumab treatment. This case strongly suggests the therapeutic effect of omalizumab in the treatment of severe intractable asthma with low serum IgE level without identifiable allergens.

Journal

Japanese Journal of Allergology

Japanese Journal of Allergology 59 (11), 1572-1579, 2010

Japanese Society of Allergology

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