Successful Treatment with Mepolizumab for Coronary Spastic Angina Associated with Eosinophilic Granulomatosis with Polyangiitis

A 46-year-old man with a history of bronchial asthma and chronic sinusitis presented to our hospital with chest pain. We suspected angina evoked by epicardial coronary spasm and performed an ergonovine provocation test to diagnose coronary spastic angina (CSA). The patient also met the diagnostic cr...

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Detalles Bibliográficos
Autores principales: Takigawa, Yuki, Fujiwara, Keiichi, Tabuchi, Isao, Kudo, Kenichiro, Hayashi, Kazuna, Matsumoto, Shoichiro, Omori, Hiroki, Matsuoka, Suzuka, Mitsumune, Sho, Watanabe, Hiromi, Sato, Akiko, Sato, Ken, Shibayama, Takuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2023
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484760/
https://www.ncbi.nlm.nih.gov/pubmed/37587056
http://dx.doi.org/10.2169/internalmedicine.0930-22
Descripción
Sumario:A 46-year-old man with a history of bronchial asthma and chronic sinusitis presented to our hospital with chest pain. We suspected angina evoked by epicardial coronary spasm and performed an ergonovine provocation test to diagnose coronary spastic angina (CSA). The patient also met the diagnostic criteria for eosinophilic granulomatosis with polyangiitis (EGPA) and was treated with 60 mg prednisolone (PSL) for EGPA-associated CSA. After PSL administration, eosinophils decreased, and angina attacks disappeared. However, when PSL was tapered to 12.5 mg, chest pain recurred. We administered mepolizumab subcutaneously and chest pain disappeared. Additional mepolizumab may be effective for EGPA with CSA.

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