Improvement of Fibromyalgia by Immunoglobulin/Histamine Complex Therapy for Chronic Urticaria and Allergic Rhinitis: A Case Report.

Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread musculoskeletal pain, often accompanied by fatigue, sleep disturbance, and cognitive symptoms. Although several treatment options are available, no curative therapy has been established. Histobulin is a histamine-fixed immunoglobulin preparation developed to regulate serum histamine levels through histaminopexy. It has been reported to have therapeutic effects in allergic rhinitis, bronchial asthma, chronic urticaria, and atopic dermatitis. We report a patient with FM and concomitant chronic urticaria and allergic rhinitis who experienced improvement in FM after Histobulin therapy. A 39-year-old Korean woman presented with a 6-year history of chronic urticaria, allergic rhinitis with rhinorrhea, and widespread musculoskeletal pain. She had previously been diagnosed with FM and had received oral treatment for pain for 13 months. At the first visit, her widespread pain index (WPI) was 9 and her symptom severity scale (SSS) score was 12. Histobulin therapy was initiated primarily for chronic urticaria and allergic rhinitis. During treatment, she reported reductions in widespread pain, finger stiffness, and insomnia, as well as improved daily functioning and reduced use of rescue analgesics. After six injections, the patient reported marked reductions in FM symptoms and in symptoms of urticaria and rhinitis. No recurrence was reported during the subsequent 3-week follow-up period. FM symptoms improved after Histobulin therapy initiated for chronic urticaria and allergic rhinitis. This observation suggests that modulation of histamine-related or immune pathways may be associated with clinical improvement. However, causality cannot be established from a single case report, and further controlled studies are required.