MIMIC OF RECURRENT ANAPHYLAXIS: A CASE REPORT

Abstract

Background: Recurrent anaphylaxis poses diagnostic and management challenges. We report a case with history of recurrent anaphylaxis.

Case presentation: A case presented a female patient with a history of recurrent idiopathic anaphylaxis. Her medical history included chronic urticaria, facial flushing, and dyspnea lasting for many years, with a history of asthma. Laboratory and imaging studies excluded pheochromocytoma and mastocytosis. Elevated total IgE (1360 IU/mL) and positive specific IgE to house dust mite and dog dander were noted. The confirmative diagnosis was chronic urticaria and uncontrolled asthma mimicking recurrent anaphylaxis. High-dose antihistamines, cyclosporine (3 mg/kg), and inhaled budesonide/formoterol provided partial relief. Initiation of omalizumab (300 mg/month) led to symptom control within 6 months and discontinuation of other therapies after 1 year.

Conclusion: Recurrent anaphylaxis requires thorough evaluation to identify and manage underlying allergic diseases that may mimic anaphylaxis, enabling targeted and effective treatment.

Keywords: recurrent anaphylaxis; chronic urticaria; allergy