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The management of angio-oedema is quite complicated because of the frequent poor response to usual treatments, including H1 antihistamines, systemic corticosteroids, immunosuppressant drugs, antileucotriene drugs or tranexamic acid. Omalizumab, an anti-immunoglobulin (Ig)-E antibody, has shown good resuts in chronic spontaneous urticaria, and might also be a good option for angio-oedema. To our knowledge, there have been eight relevant case reports published in the English literature. We report two further cases (a 55-year-old man and a 36-year-old woman) with severe chronic recurrent angio-oedema affecting the face, pharynx, hands, feet and hips. Both patients were refractory to H1 antihistamines, systemic corticosteroids and tranexamic acid. We decided to start with subcutaneous omalizumab 375 mg every other week and tapering doses up to 375 mg every 4 weeks. Both patients showed a very good response to the therapy, with clinical improvement in the first week. This response remained stable more than 3 years later.

Background: Anemia is one of the main consequences of chronic kidney disease (CKD), which causes a bone marrow response that can be determined by Magnetic Resonance Imaging. Objective: The objective of this study was to identify Bone Marrow Reconversion (BMR) by nuclear magnetic resonance imaging in patients with CKD. Methods: A descriptive study was carried in “José Carrasco Arteaga” Hospital, Cuenca-Ecuador. Images of the femurs of patients diagnosed with CKD were acquired by magnetic resonance imaging. Several variables, including age, sex, CKD stage, anemia and BMR, were taken into account. Groups are analyzed according to the stages CKD with the Anova test and a logistic regression is obtained for the BMR event with the study variables. Results: Two hundred sixteen patients were included in this analysis. Prevalence of Anemia 2/40 (5%) in Group 1 was, 3/35 (8.6%) in group 2, 17/56 (30.4%) in group 3, 23/46 (50%) in group 4 and 25/39 (64.1%) in group 5, Anova P<0.0001. BMR in Group 1 was 12 cases (30%), in group 2: 4 cases (11.4%), in group 3: 18 cases (32.1%), in group 4: 13 cases (28.3%), and group 5: 17 cases (43.6%). P=0.51. Regression equation for BMR were significant with sex (male) OR 0.193 (CI95% 0.092-0.405) P<0.0001, CKD Stage 1 OR 0.195 (0.057-0.668) P=0.009, Stage 2 OR 0.082 (0.020-0.329). Other variables were not significant. Conclusion: In this study we describe that there is an impaired Reconversion of Bone Marrow in Nuclear Magnetic Resonance Imaging in Patients with Chronic Renal Disease in stages 3, 4 and 5, despite the progressive presence of anemia. The female sex is associated with the presence of bone marrow reconversion. No statistical dependence was observed between anemia and the reconversion of bone marrow.

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