The successful use of rush oral immunotherapy with omalizumab for hen’s egg allergy

Abstract

Introduction : There are no reports regarding oral immunotherapy (OIT) with omalizumab (OMB) for hen’s egg allergy. This report describes the safety and efficacy of OIT with OMB for hen’s egg allergy. Case : A 7-year-old boy with allergies to hen’s egg and wheat, as well as exacerbated and persistent severe bronchial asthma, underwent rush OIT for anaphylaxis due to exposure to hen’s egg. His asthma had been alleviated at 9 months after initiating the rush OIT, and we began treatment with OMB. Results : The exposure threshold was 17.5 g of whole egg at the start of the OIT, and it reached 60 g via the maintenance dose at 5 months. The frequency of the patient’s symptoms was 11.6% between OIT initiation and 9 months. Between 9 months and 24 months (after starting OMB), we observed that the frequency of the patient’s symptoms decreased to 2.2-5.8%. After completing treatment, we confirmed that he could eat one whole hen’s egg. We also encouraged him to start wheat intake using a similar method, which cumulated in the patient being able to eat 700 g of udon noodles. Conclusion : OIT with OMB effectively reduced the frequency of the patient’s food allergy symptoms. These outcomes indicate that administering OIT with OMB is a potentially effective method for reducing the symptoms of hen’s egg allergy. However, tolerance acquisition should be confirmed after withdrawal of the OMB treatment.