Induction of remission of idiopathic anaphylaxis with rituximab

To the Editor: Idiopathic anaphylaxis (IA) is a life-threatening disease characterized by episodes of anaphylaxis without a recognizable specific trigger, when other possible diagnoses have been ruled out.1,2 It is more common in adults than children and in women than men, and up to one-half of affected patients are atopic.3,4 IA is by definition a diagnosis of exclusion that requires extensive evaluation by experienced allergists to rule out hidden allergens and alternative conditions. Anaphylaxis can be IgE- or IgG-mediated. [...]possible mechanisms of rituximab in IA include depletion of putative pathogenic IgG autoantibodies or depletion of circulating total or specific IgE, as measured in our patient.