Complete remission of severe idiopathic cold urticaria on interleukin-1 receptor antagonist (anakinra).
until further notice
SourceNetherlands Journal of Medicine, 67, 9, (2009), pp. 302-5
Article / Letter to editor
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Netherlands Journal of Medicine
SubjectN4i 1: Pathogenesis and modulation of inflammation; NCMLS 1: Infection and autoimmunity
A 62-year-old patient had suffered from severe cold intolerance with an urticarial rash and oropharyngeal angio-oedema upon cold exposure since early childhood. This could be provoked by the ice cube test and by exposure in a cold room. Her family history was negative, and she did not carry any mutations in the NRLP3 gene. Treatment with IL-1 receptor antagonist anakinra resulted in complete resolution of these symptoms, with a radical beneficial change in her quality of life. In recent years this patient had developed progressive neurological symptoms leading to a diagnosis of amyotrophic lateral sclerosis (ALS), which seems unrelated to the idiopathic cold urticaria. The neurological symptoms did not respond to anakinra treatment and were eventually fatal. Conclusion: We describe the first case of IL-1RA treatment in idiopathic cold urticaria with good response. Anakinra had no effect on the progression of her symptoms of ALS.
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