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August 2007

Chronic Urticaria and Monoclonal IgM Gammopathy (Schnitzler Syndrome): Report of 11 Cases Treated With Pefloxacin

Author Affiliations

Author Affiliations: Service d’Immunohématologie (Drs Asli, Brouet, Arnulf, Malphettes, and Fermand) and Service de Dermatologie (Drs Cordoliani and Rybojad), Hôpital Saint Louis, and Service de Médecine Interne, Hôpital Cochin (Dr Bienvenu), Paris, France.

Arch Dermatol. 2007;143(8):1046-1050. doi:10.1001/archderm.143.8.1046

Background  Schnitzler syndrome is characterized by chronic urticarial rash and monoclonal IgM gammopathy and is sometimes associated with periodic fever, arthralgias, and bone pain. Current treatment is unsatisfactory.

Observations  Eleven patients with Schnitzler syndrome were treated with oral pefloxacin mesylate (800 mg/d). In 10 patients, we observed a dramatic and sustained improvement of urticarial and systemic manifestations. Corticosteroid therapy could be stopped or reduced in 6 patients. In 9 patients, pefloxacin was administered for more than 6 months (≤ 10 years), with a good safety profile.

Conclusions  Pefloxacin therapy can be considered for patients with Schnitzler syndrome because it usually improves chronic urticaria and the systemic symptoms of the disease.