A New Case of Schnitzler Syndrome in Bulgaria

We describe the case of a 74-year-old Bulgarian woman with a long history of chronic urticaria with severe burning sensation, arthralgia and fever. Additional symptoms of Schnitzler such as monoclonal immunoglobulin – kappa component, elevated erythrocyte sedimentation rate and enlarged lymph nodes were detected six years after the onset of the symptoms. The first diagnoses hypersensitive vasculitis and dermatitis were established in 2009. Schnitzler syndrome was recognized and the diagnosis was established 2 years later after some examination tests. The time course of the values of IgM, C-reactive protein, erythrocyte sedimentation rate and neutrophils were presented. The mean value of IgM is 13.8 ± 2.19 g/l, the mean value of erythrocyte sedimentation rate is 48.6 ± 14.46 mm/h and the mean value of C-reactive protein – 29.8 ± 7.34 mg/l. The use of nonsteroid anti-inflammatory drugs throughout the period and corticosteroids prescribed parenterally and orally resulted in the relief of arthralgia and fever.