Failure of omalizumab and successful control with ketotifen in a patient with vibratory angio-oedema

Clin Exp Dermatol. 2013 Mar;38(2):151-3. doi: 10.1111/j.1365-2230.2012.04430.x. Epub 2012 Jun 25.

Abstract

Vibratory angio-oedema is a rare form of physical urticaria characterized by pruriginous weals and angio-oedema at the site of exposure to vibration. Severe treatment-resistant disease can occur, and is associated with significant disability. Therapy with omalizumab, a monoclonal IgG anti-IgE antibody, has been shown to be successful in several types of physical urticaria. We report a patient with vibratory angio-oedema for whom all standard treatments for urticaria, including omalizumab, failed to show a clinical benefit. Finally, ketotifen was tried, and unexpectedly reduced symptoms significantly. Ketotifen may thus represent a therapeutic option in patients with treatment-resistant vibratory angio-oedema.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angioedema / drug therapy*
  • Anti-Allergic Agents / therapeutic use*
  • Antibodies, Anti-Idiotypic / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Female
  • Histamine H1 Antagonists / therapeutic use*
  • Humans
  • Hypersensitivity, Immediate / congenital*
  • Hypersensitivity, Immediate / drug therapy
  • Ketotifen / therapeutic use*
  • Omalizumab
  • Treatment Outcome

Substances

  • Anti-Allergic Agents
  • Antibodies, Anti-Idiotypic
  • Antibodies, Monoclonal, Humanized
  • Histamine H1 Antagonists
  • Omalizumab
  • Ketotifen

Supplementary concepts

  • Vibratory angioedema