Omalizumab is a humanized monoclonal anti-Immunoglobulin E (IgE) antibody currently approved only in allergic IgE-mediated severe persistent asthma and in chronic spontaneous urticaria unresponsive to antihistamines [4] but it has been tried as off-label treatment in other diseases [5], in particular in some isolated cases of EoE with different results as described in some previous reports [6–8]. The gene discussed is IGHE; the disease is chronic idiopathic urticaria.