Hydroxychloroquine: A Safe, Effective and Inexpensive Maintenance Therapy for Chronic Spontaneous Urticaria

Background: Chronic spontaneous urticaria (CSU) is an autoimmune skin disorder that lasts for >6 weeks and may last for years. It is a disabling skin disease that impairs quality of life. Set-up treatment with antihistamines, immunosuppressives, immune modulators and lately Omalizumab are expensive or have significant side effects. In this retrospective study, we describe our experience with the use of hydroxychloroquine (HCQ) as a maintenance therapy for those with severe forms of CSU after Corticosteroids (C) induction phase. Patients and Methods: 16 adult patients (aged 44 ± 7) with severe CSU for 5 ± 1 months, were included in the study. Eight patients had attacks of angioneurotic oedema. Their previous treatments were antihistaminic and short-courses of C. Results: After 2 weeks of remission with C and HCQ 200 mg twice daily, the dose of C was tapered down and discontinued by the end of the first month. The seven days Urticaria Activity Score decreased from 30 ± 3 to 6 ± 1 by the first month and remained low at 3 ± 1 by the end of 2 years of follow-up. Moreover, IgE levels and CRP had similar trends. Remission persisted after 37 ± 9 months of follow-up. Conclusion: HCQ is a safe, efficacious and inexpensive drug for the treatment of CSU.

Association of HLA-DRB1, DQB1 Alleles with Chronic Urticaria

In order to investigate the association of genotypes of HLA-DRB1 and HLA-DQB1 alleles with the genetic susceptibility of chronic urticaria (CU), genotypes of HLA-DRB1 and HLA-DQB1 genes were detected by polymerase chain reactions with sequence-specific primers (PCR-SSP) in 42 patients with CU (19 men and 23 women, mean age 30.67±12.45 y old as well as 193 racially matched healthy persons in ethnic Han from Hubei provinece. Gene frequencies of HLA-DRB1*12, *0901 (RR=3.11, χ2=7.579, P=0.006; RR=2.47, χ2=5.684, P=0.017) were significantly increased in CU patients as compared with that in healthy people. Gene frequencies of HLA-DQB1*05 (RR=0.26, χ2=6.683, P=0.01) were significantly decreased in CU patients. It was suggested that CU was found strongly associated with HLA-DRB1*12, *0901 and HLA-DQB1*05, the former might be the genetic markers for susceptibility to CU, but the latter might play a resistive role.

Cost of Treatment of Chronic Spontaneous Urticaria in Turkey

Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system and society. The aim of this research is to estimate the cost of mild, moderate and severe CSU in Turkey and to forecast the cost of the disease from the payer (Social Security Institution—SSI) perspective. Expert opinions with Delphi technique were used in order to determine the cost items and their frequency. A questionnaire was designed to outline resources used in the out-patient, inpatient and emergency care episodes and was answered by dermatologists followed by a consensus meeting. Unit costs were calculated from the price list of the SSI. The annual total cost of treating the disease to the SSI was estimated as 262,111,978TL (94,417,870€) comprising 0.06% of the total healthcare budget in 2013. Since there is limited information about the cost of CSU in Turkey, the methodology and results of this study are unique and very important.

Pricking,Cupping and Qu Feng Tiao Ying Decoction for Treatment of Chronic Urticaria

Chronic urticaria is a commonly encountered skin illness characterized by protracted course and recurrent episodes. The author had treated 26 cases of chronic urticaria by pricking, cupping and Qu Feng Tiao Ying (QFTY) decoction (祛风调营汤the Wind-dispelling and Ying system-regulating Decoction) with satisfactory results. A report is as follows.……

mRNA profiles of cytokine receptors in unstimulated peripheral blood mononuclear cells from patients with chronic idiopathic urticaria

This present study was aimed to investigate the roles of the receptors of Thl/Th2 cytokines and chemokines in lhe pathogenesis of chronic idiopathic urticaria （CIU）. Thirty patients with CIU, 30 patients with dermographism and 30 healthy controls were randomly enrolled. Reverse transcription-PCR （RT-PCR） was used to analyze the mRNA of cytokine receptors in peripheral blood mononuclear cells （PBMCs）. The mRNA levels of tumor necro- sis factor receptor （TNFR）, interferon-7 receptor （IFN-yR）, and interleukin-10 receptor （IL-IOR） were statistically increased in the CIU group （P 〈 0.05）, while IL-2R, IL-4R, IL-6R, and IL-13R showed no significant differences between the CIU and other groups. The mRNA levels of CCR3 and CCR6 were statistically increased in the CIU group （P 〈 0.05）. The toll-like receptor 2 （TLR2） mRNA level was significantly lower in the CIU group than the healthy control group （P 〈 0.05）. These findings indicate that the regulation of mRNA of TNFR, IFN-γR, IL-IOR, CCR3, CCR6 and TLR2 may be involved in the pathogenesis of CIU.

Efficacy of the H2-receptor antagonist famotidine on chronic spontaneous urticaria in children

Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is thought to give better symptom relief. However, there are few reports on the therapeutic efficacy in pediatric patients. We retrospectively reviewed the medical records of pediatric patients with chronic spontaneous urticaria (csU) who met the following criteria. They were consulted our outpatient clinic between April 2010 and March 2012;were unsuccessfully treated with H1 antihistamines;and were treated with add-on H2-receptor antagonist (famotidine). In six patients who met the inclusion criteria (mean age 6.1 ± 5.1 years), urticaria activity score was significantly decreased from 4.3 ± 0.8 just before administration of famotidine to 1.3 ± 1.0 on the first outpatient visit within 4 weeks after the first administration of famotidine

Effectiveness and safety of acupoint catgut embedding combined with Chinese herbal medicine in chronic urticaria: A systematic review of randomized controlled trials

Objective:To evaluate the effectiveness and safety of acupoint catgut embedding(ACE)in combination with Chinese herbal medicine(CHM)in treating chronic urticaria(CU).Methods:We thoroughly searched Embase,PubMed,Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Wangfang database,Chinese Scientific Journal Database(VIP),and Chinese biomedical literature database(SinoMed)for relevant studies from inception until May 2022.Randomized controlled trials(RCTs)on ACE combined with CHM for CU were included.Literature search,data extraction,and risk of bias assessment were independently conducted by two authors.Results:A total of 15 RCTs with 1065 participants were included in this review.Five trials reported that the combined therapy showed a higher total effective rate,and four trials reported that the combined therapy was associated with a lower level of serum immunoglobulin E.Furthermore,two,four,and four trials reported that the combined therapy was more effective in reducing itching degree,size,and number of wheals,respectively.The combined therapy was reported to be associated with a lower recurrence rate in three trials,and with a fewer adverse reaction rate in two trials.Conclusions:ACE in combination with CHM appears to be a safe and effective therapy for patients with CU.Given the relatively low quality of the included trials,these findings should be interpreted cautiously.Further high-quality RCTs are needed to confirm our findings.

Based on data mining,the drug law of clinical treatment of chronic urticaria

Background:Based on clinical data mining,we introduce the medication rule and clinical application of Professor Wang Lifen in the treatment of chronic urticaria,as the reference of clinical treatment of chronic urticaria.Methods:we collected 110 traditional Chinese medicine prescriptions for the treatment of chronic urticaria,and found out tastes,functions and channel tropism of Chinese medicine.After collecting and sorting,we inputted the data into excel 2010 software and established drug electronic database.We calculated the frequency of tastes,functions and channel tropism using the Spss 20.0 and analyzed the potential relationship between the drugs using Weka 3.8.We used Cytoscape 3.6.1 to draw the related network and combine it into a new prescription.Then the clinical data of prescriptions were statistically analyzed.Results:The statistical analysis showed that the high-frequency drugs for the treatment of the disease were Gancao(Glycyrrhizae radix et rhizoma),Huangqin(Radix scutellariae),Desmopeel,Jingjie(Herba schizonepetae),parsnip,etc.,accounting for more than 69.50%of the total frequency.Moreover,the combination and drug pairs with the strongest and most commonly used high-frequency drugs were found.From the point of medicinal properties of these drugs in the treatment of chronic urticaria,the main drugs are cold,followed by warm and smooth,accounting for 70.75%of the total frequency.From the perspective of the efficacy of these drugs in the treatment of chronic urticaria,heat-clearing drugs are the main ones,followed by relieving drugs and Tonic drugs,accounting for 68.25%of the total frequency.From the perspective of medicine taste,sweet taste is the most important,followed by bitter and pungent taste,accounting for 68.00%of the total frequency.From the perspective of drugs channel tropism,the meridian of spleen is the most important,followed by the meridian of lung,liver,heart,stomach,etc.,accounting for 71.62%of the total frequency.Conclusion:According to the data mining results,traditional Chinese medicine treatment of chronic urticaria is mainly based on dispelling wind,clearing heat and removing dampness,cooling blood and detoxifying,supplemented by nourishing blood and nourishing deficiency.This data mining conforms to the law and principle of traditional Chinese medicine treatment of chronic urticaria,which has certain reference and enlightenment significance for clinical treatment of chronic urticaria.

Clinical Observation on the Effect of Chinese Medicine Five-Color Therapy on the Treatment of Children with Chronic Urticaria

Objective:To analyze the clinical treatment effect of traditional Chinese medicine five-color therapy on chronic urticaria in children.Methods:The income data target of this article is 80 children with chronic urticaria.The grouping method is a randomized method with 40 children in each group.The experimental group was treated with five-color treatment of traditional Chinese medicine,and the control group was treated with western medicine.The incidence,treatment and recurrence of adverse reactions in children with chronic urticaria were compared between the two groups.Results:Showed total effective rate of children with chronic urticaria in the experimental group was compared with the control group,P<0.05,the data showed statistical significance.Conclusion:Stated use of TCM five-color therapy in the treatment of children with chronic urticaria can significantly improve safety.

Pharmacological intervention for chronic phase of spinal cord injury

Spinal cord injury is an intractable traumatic injury. The most common hurdles faced during spinal cord injury are failure of axonal regrowth and reconnection to target sites. These also tend to be the most challenging issues in spinal cord injury. As spinal cord injury progresses to the chronic phase, lost motor and sensory functions are not recovered. Several reasons may be attributed to the failure of recovery from chronic spinal cord injury. These include factors that inhibit axonal growth such as activated astrocytes, chondroitin sulfate proteoglycan, myelin-associated proteins, inflammatory microglia, and fibroblasts that accumulate at lesion sites. Skeletal muscle atrophy due to denervation is another chronic and detrimental spinal cord injury–specific condition. Although several intervention strategies based on multiple outlooks have been attempted for treating spinal cord injury, few approaches have been successful. To treat chronic spinal cord injury, neural cells or tissue substitutes may need to be supplied in the cavity area to enable possible axonal growth. Additionally, stimulating axonal growth activity by extrinsic factors is extremely important and essential for maintaining the remaining host neurons and transplanted neurons. This review focuses on pharmacotherapeutic approaches using small compounds and proteins to enable axonal growth in chronic spinal cord injury. This review presents some of these candidates that have shown promising outcomes in basic research(in vivo animal studies) and clinical trials: AA-NgR(310)ecto-Fc(AXER-204), fasudil, phosphatase and tensin homolog protein antagonist peptide 4, chondroitinase ABC, intracellular sigma peptide,(-)-epigallocatechin gallate, matrine, acteoside, pyrvate kinase M2, diosgenin, granulocyte-colony stimulating factor, and fampridine-sustained release. Although the current situation suggests that drug-based therapies to recover function in chronic spinal cord injury are limited, potential candidates have been identified through basic research, and these candidates may be subjects of clinical studies in the future. Moreover, cocktail therapy comprising drugs with varied underlying mechanisms may be effective in treating the refractory status of chronic spinal cord injury.

Current status of drug therapy for chronic hepatitis B

In this editorial,we comment on the article by Meng et al.Chronic hepatitis B(CHB)is a significant global health problem,particularly in developing countries.Hepatitis B virus(HBV)infection is one of the most important risk factors for cirrhosis and hepatocellular carcinoma.Prevention and treatment of HBV are key measures to reduce complications.At present,drug therapy can effectively control virus replication and slow disease progression,but completely eliminating the virus remains a challenge.Anti-HBV treatment is a long-term process,and there are many kinds of antiviral drugs with different mechanisms of action,it is essential to evaluate the safety and efficacy of these drugs to reduce side effects and improve patients’compliance.We will summarize the current status of CHB drug treatment,hoping to provide a reference for the selection of clinical antiviral drugs.

Mimicking aneurysm in a patient with chronic occlusion of the left middle cerebral artery

The chronic occlusion of intracranial arteries generally has no or mild clinical symptoms,and the clinical symptoms of acute cerebral artery occlusion are mostly manifested as severe cerebral infarction symptoms,which often make early diagnosis difficult,thus losing the best treatment opportunity.Once cerebral infarction occurs,the consequences are difficult to recover.This is also an important reason for the high misdiagnosis rate and mortality of this disease.In this paper,the characteristics of the disease were analyzed to provide clinical reference.

Motivational interviewing in postoperative rehabilitation and chronic disease management: Current findings and future research directions

This editorial highlights a recently published study examining the effectiveness of music therapy combined with motivational interviewing(MI)in addressing an-xiety and depression among young and middle-aged patients following percuta-neous coronary intervention.It further explores existing evidence and potential future research directions for MI in postoperative rehabilitation and chronic disease management.MI aims to facilitate behavioral change and promote healthier lifestyles by fostering a trusting relationship with patients and enhan-cing intrinsic motivation.Research has demonstrated its effectiveness in posto-perative recovery for oncological surgery,stroke,organ transplants,and gastroin-testinal procedures,as well as in managing chronic conditions such as diabetes,obesity,and periodontal disease.The approach is patient-centered,adaptable,cost-effective,and easily replicable,though its limitations include reliance on the therapist’s expertise,variability in individual responses,and insufficient long-term follow-up studies.Future research could focus on developing individualized and precise intervention models,exploring applications in digital health management,and confirming long-term outcomes to provide more compre-hensive support for patient rehabilitation.

Challenges and improvement strategies in the hospitalization of chronic multimorbid patients

BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot program.Chronic diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient outcomes.If proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid patients.AIM To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital care.METHODS The study employed a descriptive longitudinal approach,analyzing data from the Basic Minimum Data Set(BMDS)to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.RESULTS The study employed a descriptive longitudinal approach,analyzing data from the BMDS to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.CONCLUSION This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary approach.The coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient complexity.The superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of care to be replicated.

Predicting colorectal adenomatous polyps in patients with chronic liver disease: A novel nomogram

BACKGROUND Colorectal polyps are commonly observed in patients with chronic liver disease(CLD)and pose a significant clinical concern because of their potential for malignancy.AIM To explore the clinical characteristics of colorectal polyps in patients with CLD,a nomogram was established to predict the presence of adenomatous polyps(AP).METHODS Patients with CLD who underwent colonoscopy at Tianjin Second People’s Hospital from January 2020 to May 2023 were evaluated.Clinical data including laboratory results,colonoscopy findings,and pathology reports were collected.Key variables for the nomogram were identified through least absolute shrinkage and selection operator regression,followed by multivariate logistic regression.The performance of the model was evaluated using the area under the receiver area under curve,as well as calibration curves and decision curve analysis.RESULTS The study enrolled 870 participants who underwent colonoscopy,and the detection rate of AP in patients with CLD was 28.6%.Compared to individuals without polyps,six risk factors were identified as predictors for AP occurrence:Age,male sex,body mass index,alcohol consumption,overlapping metabolic dysfunction-associated steatotic liver disease,and serum ferritin levels.The novel nomogram(AP model)demonstrated an area under curve of 0.801(95%confidence interval:0.756-0.845)and 0.785(95%confidence interval:0.712-0.858)in the training and validation groups.Calibration curves indicated good agreement among predicted and actual probabilities(training:χ^(2)=11.860,P=0.157;validation:χ^(2)=7.055,P=0.530).The decision curve analysis underscored the clinical utility of the nomogram for predicting the risk of AP.CONCLUSION The AP model showed reasonable accuracy and provided a clinical foundation for predicting the occurrence of AP in patients with CLD,which has a certain predictive value.

C-X-C chemokine receptor type 5+CD8+T cells as immune regulators in hepatitis Be antigen-positive chronic hepatitis B under interferonalpha treatment

BACKGROUND C-X-C chemokine receptor type 5(CXCR5)+CD8+T cells represent a unique immune subset with dual roles,functioning as cytotoxic cells in persistent viral infections while promoting B cell responses.Despite their importance,the specific role of CXCR5+CD8+T cells in chronic hepatitis B(CHB),particularly during interferon-alpha(IFN-α)treatment,is not fully understood.This study aims to elucidate the relationship between CXCR5+CD8+T cells and sustained serologic response(SR)in patients undergoing 48 weeks of pegylated IFN-α(peg-IFN-α)treatment for CHB.AIM To elucidate the relationship between CXCR5+CD8+T cells and sustained SR in patients undergoing 48 weeks of peg-IFN-αtreatment for CHB.METHODS This study enrolled 60 patients with hepatitis Be antigen(HBeAg)-positive CHB undergoing 48 weeks of peg-IFN-αtreatment.Participants were assessed for eligibility based on criteria such as persistent HBsAg-positive status for at least six months,HBeAb-negative,hepatitis B virus DNA levels exceeding 2×104 copies/mL,and alanine aminotransferase(ALT)levels between 2 and 10 times the upper limit of normal.Blood samples were collected at baseline and at weeks 12,24,48,and a 24-week treatment-free follow-up(week 72)to measure serum interleukin(IL)-21 concentration via ELISA and to analyze CXCR5 and programmed death-ligand 1(PD-L1)expression on CD8+T cells by flow cytometry,CXCR5 is a chemokine receptor that directs immune cells to specific tissues,while PD-L1 is a protein that regulates immune responses by inhibiting T cell activity.RESULTS Patients with CHB exhibited significantly lower levels of circulating CXCR5+CD8+T cells compared to healthy controls(P<0.01).Notably,CXCR5+CD8+T cells were prominently expressed in patients who achieved sustained SR compared to non-SR(NSR).A significant correlation was observed between CXCR5 and PD-L1 expression(r=-0.189,P=0.002).However,there was no significant correlation between serum IL-21 levels and CXCR5+CD8+lymphocytes(r=-0.03,P=0.625)or serum ALT levels(r=0.026,P=0.678).CONCLUSION The enhanced expression of CXCR5+CD8+T cells in patients achieving HBeAg seroconversion during IFN-αtreatment suggests that these cells play a crucial role in antiviral immune responses against hepatitis B.This study highlights the potential of CXCR5+CD8+T cells as immune regulators in CHB,which may inform future therapeutic strategies to optimize antiviral treatments.

Inflammasome links traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease

Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.

Chronic Urticaria Due to Allergy to Wheat Alpha-Amylase Inhibitor Proteins

Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of wheals, angioedema, or both, for at least 6 weeks, due to known or unknown causes [1]. In some patients who present a CSU with daily or almost daily symptoms a type I allergy could be the underlying cause. We present one adult patient with chronic urticaria who was finally diagnosed as a non-occupational case of IgE-mediated wheat allergy manifested following exposure by 3 different routes: inhalation (rhinitis and bronchial asthma), dermal absorption (contact urticaria) and ingestion (systemic chronic urticaria). We were able to detect the culprit proteins by immunoblotting. Serum IgE binds mainly to alpha-amylase/trypsin inhibitors and, to a lesser extent, to other proteins associated with food allergy to grains (e.g. beta-glucanase, serpin, peroxidase). In our opinion, skin prick tests with a food standard battery could help in the etiological diagnosis of chronic urticaria. The identification of responsible allergens could be difficult because only a few complex in vitro techniques allow detecting the allergy to several proteins.

Chronic Refractory Idiopathic Urticaria

Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, tailored to the severity of the condition, which can enhance overall quality of life. Aim: In this article, we outline a systematic approach to managing chronic urticaria, while also elucidating the available treatment strategies for cases that prove resistant to conventional therapies. To illustrate our points, we present a clinical case as a practical example. Case Presentation: Here, we present a patient with CSU since childhood who presented in the context of refractory hives and generalized arthralgia that responded well to omalizumab therapy with no further relapse. Conclusion: Omalizumab is a biological agent that offers a potential treatment option for CSU. It is available for individuals twelve years and older who have not responded well to conventional treatments. It has demonstrated good efficacy with a relatively low rate of clinically significant adverse effects. Nonetheless, there is a dearth of research regarding the optimal method for tapering the dosage and determining the duration of treatment.

Chronic Spontaneous Urticaria on Omalizumab Therapy and Latent Tuberculosis Infection: A New Case Report

Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.