New-onset of eosinophilic granulomatosis with polyangiitis without eosinophilia and eosinophilic infiltration under benralizumab treatment: A case report.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 101761026 Publication Model: Print Cited Medium: Internet ISSN: 2472-5625 (Electronic) Linking ISSN: 24725625 NLM ISO Abbreviation: Mod Rheumatol Case Rep Subsets: MEDLINE
    • Publication Information:
      Publication: 2021- : Oxford : Oxford University Press
      Original Publication: Abingdon, Oxfordshire : Taylor & Francis, [2017]-
    • Subject Terms:
    • Abstract:
      Eosinophilic granulomatosis with polyangiitis (EGPA) is a small- to medium-vessel necrotising vasculitis and eosinophilic inflammation. Mepolizumab, an anti-interleukin-5 (IL-5) monoclonal antibody has been approved in Japan since 2018 for refractory EGPA treatment. Benralizumab, an anti-IL-5 receptor monoclonal antibody, also has been reported to reduce the glucocorticoid dose in patients with refractory EGPA. On the other hand, several investigators have demonstrated new-onset EGPA under biologics, and it is unclear whether this treatment for severe allergic diseases can prevent the development of EGPA. Herein, we report a case of new-onset EGPA under benralizumab treatment. The patient had fever, weight loss, muscle pain, and paraesthesia, the serum eosinophil count was 0/μL, and the biopsy showed necrotizing vasculitis without eosinophilic infiltration. She was diagnosed as having EGPA and treated with high-dose glucocorticoid and intravenous cyclophosphamide, with a good response. Our case report indicates that anti-IL-5 agents may mask the development of EGPA and clinicians should be aware of the development of EGPA during anti-IL-5 agents.
      (© Japan College of Rheumatology 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].)
    • Contributed Indexing:
      Keywords: Benralizumab; eosinophilia; eosinophilic granulomatosis with polyangiitis; eosinophilic infiltration
    • Accession Number:
      71492GE1FX (benralizumab)
      0 (Glucocorticoids)
    • Publication Date:
      Date Created: 20230527 Date Completed: 20240101 Latest Revision: 20240309
    • Publication Date:
      20240309
    • Accession Number:
      10.1093/mrcr/rxad028
    • Accession Number:
      37243733