Therapy resistant urticaria as a long-term symptom of an incomplete Schnitzler syndrome

Table 2 Laboratory values

Laboratory values	1st visit (03/2013)	*Time of diagnosis (02/2022)
CRP (mg/dL [0.0–0.5])	1.4 (H)	3.1 (H)
WBC (10^9/l [4.0–10.0])	9.98	7.93
IgM-Concentration (mg/dL [40–230])	148	211#
Immunofixation*	–	Confirmed Paraproteinemia of IgM/kappa*
Complement—C4 (mg/dL [10–40])	23.3	80 (H)

Cytologicals and histological analysis
bone marrow biopsy	Negative for Systemic Mastocytosis
skin biopsy	Teleangiectasia macularis eruptiva perstans; Immunohistological negative for CD2, elevated numbers of CD25 positive mastcells

Infectious diseases or autoimmunity
CMV (IgG and IgM)	Negative	ANA qual. IF*	Negative
Lues serology	Negative	dsDNA-AB*	Negative
HIV-AB screen	Negative	ENA-AB*	Negative
HAV (IgG and IgM)	Negative	Rheumatoid factor*	Negative
HBeAg	Negative	Anti-TPO-AB	Negative

^# IgM concentration doesn’t need to be elevated as criterion [2]
(H) high values above norm
Values indicated with asterisk (*) were measured at the time of first diagnosis. Other values at the first visit or another time before 02/2022
CRP C-reactive protein, WBC white blood cells, IgM immunoglobulin M, CMV cytomegalovirus, HIV human immunodeficiency virus, AB antibody, HAV hepatitis A-virus, HBeAg hepatitis B e-antigen, ANA qual. IF antinuclear antibodies qualified by immunofluorescence, dsDNA-AB double-stranded DNA antibodies, ENA-AB extractable nuclear antigen antibodies, Anti-TPO anti-thyroid peroxidase. Figure 1—Figurative representation of recorded burden of disease, treatments, and diagnosis over the time

ISSN: 1710-1492