Omalizumab in the treatment of latex fruit syndrome
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1
Universidad de Antioquia, Antioquia, Colombia
Introduction
Latex fruit syndrome involves cross-reactivity between inhaled and food allergens. The association between latex allergy and fruit allergy reaches to 58%. The foods most frequently involved are chestnut, avocado, banana, and kiwi, although many others are involved. The mainstays of management for patients with this disease are treatment of present reaction and avoid exposure to allergens for prevention of future reactions. Omalizumab is a recombinant humanized monoclonal antibody that selectively binds to immunoglobulin E (IgE) reducing its levels of circulating, besides decline expression of IgE high-affinity receptors on mast cells and basophils, interrupting the subsequent allergic inflammatory cascade. It is FDA approved for the treatment of moderate-to-severe uncontrolled allergic asthma, recently also for the treatment of chronic spontaneous urticaria. Its use in other allergic diseases is still off-label.
Objective
Description of latex fruit syndrome treated with Omalizumab
Methods
A systematic literature search was conducted in the following databases: PubMed, Embase and ScienceDirect, using the keywords: Latex fruit syndrome, Omalizumab, anaphylaxis and food allergy, finding reports of its use in latex allergy and food allergy independently, with few case reports of its use in latex fruit syndrome. Is then performed one case report of a patient diagnosed with latex fruit syndrome successfully treated with Omalizumab.
Results
A 26-year-old man, veterinarian, with a history of allergic asthma, moderate/severe persistent rhinitis, perennial conjunctivitis, who had presented several anaphylactic reactions (severe asthma attack more skin involvement) in contact with latex, dog dander and consumption of kiwi and avocado. His general physical examination was normal except for having an erythematous nasal mucosa. Laboratory findings were: Total Inmmunoglobulin (Ig) E was found to be high (403.5 IU/ml), full blood count with hemoglobin: 16.9, hematocrit 49.1, leukocytes: 8470, neutrophils: 4400, lymphocytes: 2730, eosinophils: 660, platelets: 268000; showing eosinophilia. Skin prick test were found positive for Latex (10 mm), Dermatophagoides farina (10 mm), Dermatophagoides pteronyssinus (9 mm), Blomia Tropicalis (9 mm), dog dander (5 mm), cockroach (4 mm), avocado (4 mm), Kiwi (3 mm). Due to the severity of the symptoms presented and the constant exposure to allergens to which the patient is allergic, it was decided to start with Omalizumab achieving total control of symptoms and improvement of quality of life. Currently controlled with Omalizumab 300 mgr monthly dose.
Conclusion
Omalizumab is presented as a useful tool in IgE-mediated allergic diseases other than asthma and urticaria.
References
1. Cabañes N et al. J Investig Allergol Clin Immunol 2012; Vol. 22(5): 313-330
2. Sánchez J et al. Allergol Immunopathol. 2012;40(5):306-315.
3. Rocha R et al. Eur J Pediatr (2011) 170:1471-1474.
Keywords:
Latex fruit syndrome,
Omalizumab,
Anaphylaxis,
Latex,
food allergy
Conference:
IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología, Medellin, Colombia, 13 Oct - 16 Oct, 2015.
Presentation Type:
Poster Presentation
Topic:
Allergy
Citation:
Herrera Morales
CI,
Gómez Henao
CM and
Cardona Villa
R
(2015). Omalizumab in the treatment of latex fruit syndrome.
Front. Immunol.
Conference Abstract:
IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología.
doi: 10.3389/conf.fimmu.2015.05.00270
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Received:
15 May 2015;
Published Online:
14 Sep 2015.
*
Correspondence:
Dr. Cristina I Herrera Morales, Universidad de Antioquia, Antioquia, Medellín, Antioquia, 1234, Colombia, crishm@hotmail.com