Pacjentka z ciężką astmą wyłączona z leczenia omalizumabem po 12 tygodniach

We present the case of 20-year-old woman with the short history of severe course of asthma since its beginning. The patient met the inclusion criteria to omalizumab therapy in the program reimbursed by Polish Health Fund, so we expected that this therapy will enable to improve asthma control in the patient and decrease the dose of oral steroids or completely withdraw them. However within twelve weeks of therapy, the day of omalizumab application had to be rescheduled many times because of infectious asthma exacerbations. Moreover, in between exacerbations, asthma remained uncontrolled in spite of the very high doses of inhaled steroids and bronchodilators. Only on the day of last omalizumab injection, the patient reported better condition, and we observed improvement in spirometry and questionnaires score. We hoped that patient started to respond to the therapy. In the twelfth week of therapy, the patient reported that she became pregnant and had to be excluded from the therapeutical program. From the patients’ findings, high eosinophil count in peripheral blood as well as in broncho-alveolar lavage fluid were remarkable and chronic sinusitis preceded asthma diagnose.