Omalizumab
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Omalizumab Churg-Strauss syndrome: case report A 62-year-old patient [sex not stated] developed ChurgStrauss syndrome following treatment with omalizumab [Xolair] for severe asthma. Because of corticoresistance associated with their asthma, the patient started treatment with omalizumab [dosage not stated]. After 18 months’ therapy, the patient noted an improvement in the asthma but reported a gradual weight loss of 6kg and the appearance of swelling in the left cheek associated with febrile peaks. The patient presented with persistent rhinitis and nasal polyposis, as well as with progressively worsening abdominal pain associated with palpable hypogastric swelling. MRI and facial scans showed an infiltration of subcutaneous tissue of the left cheek and a thickening of the masticatory muscles with uptake of contrast material. Abdominal scans revealed an infiltration of the retroperitoneal and mesenteric fat, assuming a pseudotumoural aspect in the subperitoneum. The mesenteric vessels were permeable and of normal size. A chest scan did not show any parenchymal or mediastinal abnormalities. Laboratory investigations revealed hypereosinophilia (2070/mm3; normal < 500). Testing for antineutrophil cytoplasmic antibodies was negative. Biopsy of the cheek swelling showed eosinophilic cellulitis without vasculitis. Nasal, bronchial and muscle biopsies also revealed significant eosinophilic infiltration of tissues. On the basis of the clinical, histological and biological data, the patient was diagnosed with a rare form of ChurgStrauss syndrome [treatment and patient outcome not stated]. Szwarc D, et al. [Churg-Strauss syndrome under omalizumab treatment: a rare visceral manifestation]. Journal de Radiologie 90: 1737-9, No. 11, Part 1, Nov 803008312 2009 [French; summarised from a translation] - France
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Reactions 20 Mar 2010 No. 1293
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