# Rapid Clinical Response to Omalizumab Treatment in Pediatric Acute Urticaria Associated with Mycoplasma Infection: A Two-Case Report

## TL;DR

Two children with severe hives caused by a Mycoplasma infection improved quickly after treatment with Omalizumab, a drug typically used for chronic hives in adults.

## Contribution

This is the first report of Omalizumab's successful use in treating acute urticaria in children linked to Mycoplasma infection.

## Key findings

- Omalizumab rapidly improved symptoms in two pediatric cases of acute urticaria unresponsive to standard treatments.
- The findings suggest IgE-mediated mechanisms may play a role in Mycoplasma-associated acute urticaria in children.
- These cases indicate Omalizumab could have broader applications beyond chronic spontaneous urticaria.

## Abstract

Background and Clinical Significance: Urticaria in children is generally self-limiting, and infections are a significant trigger. While anti-IgE therapy (Omalizumab) is approved for chronic spontaneous urticaria (CSU) in adolescents and adults, its role in treating acute urticaria, particularly in children, is not well defined. Case Presentation: We present two pediatric cases of acute urticaria associated with Mycoplasma pneumoniae infection. Both cases were refractory to antihistamines and corticosteroids but showed rapid response with anti-IgE treatment. Conclusions: This is the first case report in the literature of pediatric acute urticaria treated with Omalizumab. These cases suggest a potential role for IgE-mediated pathways in acute urticaria related to Mycoplasma infection and raise the question of broader applications for Omalizumab beyond CSU.