Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Sep 22:9:714111.
doi: 10.3389/fped.2021.714111. eCollection 2021.

Case Report: Off-Label Use of Omalizumab in a 6-Year-Old Boy With ASD Ameliorated Severe Allergic Rhinitis and Subsequently Improved Behavioral Symptoms

Xue-Jun Kong  1   2 , Cullen Clairmont  1 , Bryan Wang  1
Affiliations
Case Reports

Case Report: Off-Label Use of Omalizumab in a 6-Year-Old Boy With ASD Ameliorated Severe Allergic Rhinitis and Subsequently Improved Behavioral Symptoms

Xue-Jun Kong et al. Front Pediatr. .

Abstract

Children with ASD have elevated risk for developing allergic symptoms. The severity of allergic symptoms can exacerbate behavioral problems in children with ASD. Omalizumab, an anti-IgE antibody, has previously shown efficacy in treating allergic rhinitis and behavioral problems in a 12-year-old child with ASD. The present case report provides robust characterization of behavioral improvement in a 6-year-old child with ASD, allergic rhinitis, and autoimmune disorder. A 6-year-old boy with ASD and Hashimoto's disease presented to the clinic with severe allergic rhinitis, irritability, and language delay. After other treatments failed to improve symptoms, our patient was treated with omalizumab at 300 mg/month via subcutaneous injection for a total of 6 months. Marked improvement in allergic symptoms were observed at 2 months into treatment and were maintained through the treatment period. At the conclusion of the treatment period, results from multiple behavioral questionnaires, including the SRS-2, ABC, RBS-R, and PSQI, demonstrated substantial improvement in ASD-related behavioral symptoms. In this case, omalizumab markedly improved ASD-related and sleep behavior in a 6-year-old with ASD, allergic rhinitis, and autoimmune disorder. Future studies with larger patient populations are warranted to investigate the efficacy of omalizumab in patients with ASD and allergy symptoms.

Keywords: allergic rhinitis; anxiety; autism spectrum disorder; omalizumab; sleep disturbance.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Case Timeline. Color bar is a qualitative, visual representation of patient overall symptom severity over the course of the case, wherein red indicates severe symptomology and green mild/no symptomology. Red diamond timepoints indicate months during which omalizumab treatment was administered.
Figure 2
Figure 2
Social Responsiveness Scale-2 (SRS) sub-scores prior to the initiation of omalizumab (blue) and after the 6 month treatment period (red).
Figure 3
Figure 3
Aberrant Behavior Checklist (ABC) sub-scores prior to the initiation of omalizumab (blue) and after the 6 month treatment period (red).
Figure 4
Figure 4
Repetitive Behavior Scale-Revised (RBS-R) sub-scores prior to the initiation of omalizumab (blue) and after the 6 month treatment period (red).
Figure 5
Figure 5
Pittsburgh Sleep Quality Index (PSQI) sub-scores prior to the initiation of omalizumab (blue) and after the 6 month treatment period (red).
Figure 6
Figure 6
Total scores before initiation of omalizumab (blue) and after the treatment period (red) for the Epworth Sleepiness Scale (ESS), General Anxiety Disorder 7-item (GAD-7) scale, Clinical Global Impressions – Severity (CGI-S) scale, and the Rhinitis Control Assessment Test (RCAT). In contrast to other parameters, RCAT scores indicate better improvement with higher scores, while the rest of the tests indicate better improvement with lower scores. The Clinical Global Impressions - Improvement (CGI-I) was rated a 2 at the conclusion of the treatment period, indicating “much improved” symptoms.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Maenner MJ. Prevalence of autism spectrum disorder among children aged 8 years autism and developmental disabilities monitoring network, 11 sites, United States, 2016. MMWR Surv Summ. (2020) 69:1–12. - PMC - PubMed
    1. Krakowiak P, Goodlin-Jones B, Hertz-Picciotto I, Croen LA, Hansen RL. Sleep problems in children with autism spectrum disorders, developmental delays, and typical development: a population-based study. J Sleep Res. (2008) 17:197–206. 10.1111/j.1365-2869.2008.00650.x - DOI - PMC - PubMed
    1. Lugo J, Fadeuilhe C, Gisbert L, Setien I, Delgado M, Corrales M, et al. . Sleep in adults with autism spectrum disorder and attention deficit/hyperactivity disorder: a systematic review and meta-analysis. Eur. Neuropsychopharmacol. (2020) 38:1–24. 10.1016/j.euroneuro.2020.07.004 - DOI - PubMed
    1. Antony MM, Cox BJ, Enns MW, Bieling PJ, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychol Assess. (1998) 10:176–81. 10.1037/1040-3590.10.2.176 - DOI
    1. Ainsworth K, Robertson AE, Welsh H, Day M, Watt J, Barry F, et al. . Anxiety in adults with autism: Perspectives from practitioners. Res Autism Spec Dis. (2020) 69:101457. 10.1016/j.rasd.2019.101457 - DOI

Publication types

LinkOut - more resources