Angiœdèmes récidivants révélateurs d’une loase

Abstract

Case report10% of chronic spontaneous urticarias manifest as isolated angiœdemas. We describe the observation of a 23-year old woman, addressed to start a treatment with omalizumab for a chronic spontaneous urticaria that did not respond to a well conducted antihistamine treatment. The etiological assessment showed 3 G/L hypereosinophilia. An ophthalmological examination was conducted because the patient complained of eye pain and identified a loiasis filariasis. Microfilaremia remained negative but filariasis serology was positive. Treatment of the parasitosis has resulted in the remission of the symptoms. DiscussionLoiasis is a cutaneous helminthiasis from the nemathelminths group which is transmitted by the chryops (horsefly) endemic in central Africa in forest areas. Symptoms are due to the crawling under the skin of the adult worm giving painful and transient œdemas of the forearms called Calabar œdemas, and due to its passage into the conjonctiva giving photophobia, tearing, ocular pruritus. Diagnosis is made on microfilaremia blood test associated with hypereosinophilia. The treatment is diéthylcarbamazine (Notézine®) in an hospital setting. ConclusionParasitosis should be mentioned when recurrent angiœdemas are isolated, when hypereosinophilia is associated, and when occurring at regular intervals.