Application of Precision Medicine to the Treatment of Anaphylaxis

Marina Labella; Marlene Garcia-Neuer; Mariana Castells


Curr Opin Allergy Clin Immunol. 2018;18(3):190-197. 

In This Article

Clinical Vignette: Welcome, There is Hope

A 32-year-old woman was referred by her general practitioner (GP) to our allergy outpatient clinic with a 1 year history of episodic hives and angioedema on her forearms, legs, torso and face. On one occasion cutaneous manifestations were accompanied by itchy eyes, wheezing and chest tightness. These symptoms resolved within 24–48 h after onset and appeared immediately before or at the onset of her monthly menstrual cycle. She was then symptom free for 3–4 weeks without recurrence. She had been previously diagnosed with chronic idiopathic urticaria by her GP and controlled her symptoms with Benadryl (Johnson and Johnson, New Brunswick, New Jersey, USA) (Difenhidramyne) 100 mg and Zantac (Ranitine) 150 mg. She had been on uninterrupted oral contraceptive pills for the past 15 years and was attempting to conceive via IVF. She was worried about the suspected diagnosis of progestogen hypersensitivity could affect her possibility of pregnancy. How can we help our patient? Does the risk of anaphylaxis in women with progestogen hypersensitivity prevent successful pregnancies? Is there a safe and effective way to manage and prevent anaphylaxis in this case?