Rapid Clinical Response to Omalizumab Treatment in Pediatric Acute Urticaria Associated with Mycoplasma Infection: A Two-Case Report

<b>Background and Clinical Significance</b>: Urticaria in children is generally self-limiting, and infections are a significant trigger. While anti-IgE therapy (Omalizumab) is approved for chronic spontaneous urticaria (CSU) in adolescents and adults, its role in treating acute urticaria, particularly in children, is not well defined. <b>Case Presentation</b>: We present two pediatric cases of acute urticaria associated with <i>Mycoplasma pneumoniae</i> infection. Both cases were refractory to antihistamines and corticosteroids but showed rapid response with anti-IgE treatment. <b>Conclusions</b>: This is the first case report in the literature of pediatric acute urticaria treated with Omalizumab. These cases suggest a potential role for IgE-mediated pathways in acute urticaria related to Mycoplasma infection and raise the question of broader applications for Omalizumab beyond CSU.