Rapid oral tolerance induction to isoniazid and pyrazinamide and controlled administration of ethambutol: clinical case.

leukotrienes in mast cells. Although no reported measurements of leukotrienes in patients with mastocytosis between or during clinical flares are available, anecdotal reports suggest a transient response to leukotriene antagonists used to treat recalcitrant symptoms. Symptomatic relief has been observed within the first month of treatment but tends to wane thereafter. The role of leukotriene receptor antagonists in TMEP has not been evaluated before. In our patient montelukast has resulted in an abrupt relief of symptoms. In conclusion, the long term prognosis of TMEP is unknown because reported follow-up information of childhood cases is lacking. Currently, no curative therapy exists. Because it is an infrequent disorder, controlled studies evaluating efficacy of treatment modalities cannot be carried out and treatment is usually based on data evolving from case reports. To the best of our knowledge this is the first TMEP case to be treated with montelukast. We have achieved an abrupt and persistent clinical response through the use of montelukast. However, to establish its role in TMEP and identify the pathogenetic mechanisms involved, more studies need to be implemented. We conclude that a trial of leukotriene receptor antagonist drugs should be considered in patients with TMEP.