Cargando…

Idiopathic hypereosinophilic syndrome in remission with benralizumab treatment after relapse with mepolizumab

We report a patient with idiopathic hypereosinophilic syndrome (I‐HES) who achieved remission with benralizumab after relapsing on mepolizumab. An 83‐year‐old man was admitted to Showa General Hospital after presenting with hypoxaemia and multiple erythematous lesions. He showed a marked increase in...

Descripción completa

Detalles Bibliográficos
Autores principales: Fujii, Koki, Takahashi, Hidenori, Hayakawa, Nami, Iwasaki, Yoshinobu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511777/
https://www.ncbi.nlm.nih.gov/pubmed/33005423
http://dx.doi.org/10.1002/rcr2.665
_version_ 1783586023270252544
author Fujii, Koki
Takahashi, Hidenori
Hayakawa, Nami
Iwasaki, Yoshinobu
author_facet Fujii, Koki
Takahashi, Hidenori
Hayakawa, Nami
Iwasaki, Yoshinobu
author_sort Fujii, Koki
collection PubMed
description We report a patient with idiopathic hypereosinophilic syndrome (I‐HES) who achieved remission with benralizumab after relapsing on mepolizumab. An 83‐year‐old man was admitted to Showa General Hospital after presenting with hypoxaemia and multiple erythematous lesions. He showed a marked increase in blood eosinophil count. Skin biopsy revealed an invasion of eosinophils in the dermis. He was diagnosed with I‐HES. He was commenced on prednisolone 40 mg/day with a plan to wean this over time after pulse steroid therapy for three days. Mepolizumab was added when the prednisolone dose was 25 mg/day. Unfortunately, at a prednisolone dose of 5 mg/day, there was evidence of disease progression and the patient was switched to benralizumab. Prednisolone was tapered again and, finally, the patient was in remission. Benralizumab targets interleukin (IL)‐5R and induces antibody‐dependent cell‐mediated cytotoxicity, thereby reducing the eosinophil counts in the tissue. This can be attributed to the therapeutic efficacy against I‐HES. We believe this report may help develop novel therapeutic strategies for I‐HES.
format Online
Article
Text
id pubmed-7511777
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher John Wiley & Sons, Ltd
record_format MEDLINE/PubMed
spelling pubmed-75117772020-09-30 Idiopathic hypereosinophilic syndrome in remission with benralizumab treatment after relapse with mepolizumab Fujii, Koki Takahashi, Hidenori Hayakawa, Nami Iwasaki, Yoshinobu Respirol Case Rep Case Reports We report a patient with idiopathic hypereosinophilic syndrome (I‐HES) who achieved remission with benralizumab after relapsing on mepolizumab. An 83‐year‐old man was admitted to Showa General Hospital after presenting with hypoxaemia and multiple erythematous lesions. He showed a marked increase in blood eosinophil count. Skin biopsy revealed an invasion of eosinophils in the dermis. He was diagnosed with I‐HES. He was commenced on prednisolone 40 mg/day with a plan to wean this over time after pulse steroid therapy for three days. Mepolizumab was added when the prednisolone dose was 25 mg/day. Unfortunately, at a prednisolone dose of 5 mg/day, there was evidence of disease progression and the patient was switched to benralizumab. Prednisolone was tapered again and, finally, the patient was in remission. Benralizumab targets interleukin (IL)‐5R and induces antibody‐dependent cell‐mediated cytotoxicity, thereby reducing the eosinophil counts in the tissue. This can be attributed to the therapeutic efficacy against I‐HES. We believe this report may help develop novel therapeutic strategies for I‐HES. John Wiley & Sons, Ltd 2020-09-23 /pmc/articles/PMC7511777/ /pubmed/33005423 http://dx.doi.org/10.1002/rcr2.665 Text en © 2020 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Fujii, Koki
Takahashi, Hidenori
Hayakawa, Nami
Iwasaki, Yoshinobu
Idiopathic hypereosinophilic syndrome in remission with benralizumab treatment after relapse with mepolizumab
title Idiopathic hypereosinophilic syndrome in remission with benralizumab treatment after relapse with mepolizumab
title_full Idiopathic hypereosinophilic syndrome in remission with benralizumab treatment after relapse with mepolizumab
title_fullStr Idiopathic hypereosinophilic syndrome in remission with benralizumab treatment after relapse with mepolizumab
title_full_unstemmed Idiopathic hypereosinophilic syndrome in remission with benralizumab treatment after relapse with mepolizumab
title_short Idiopathic hypereosinophilic syndrome in remission with benralizumab treatment after relapse with mepolizumab
title_sort idiopathic hypereosinophilic syndrome in remission with benralizumab treatment after relapse with mepolizumab
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511777/
https://www.ncbi.nlm.nih.gov/pubmed/33005423
http://dx.doi.org/10.1002/rcr2.665
work_keys_str_mv AT fujiikoki idiopathichypereosinophilicsyndromeinremissionwithbenralizumabtreatmentafterrelapsewithmepolizumab
AT takahashihidenori idiopathichypereosinophilicsyndromeinremissionwithbenralizumabtreatmentafterrelapsewithmepolizumab
AT hayakawanami idiopathichypereosinophilicsyndromeinremissionwithbenralizumabtreatmentafterrelapsewithmepolizumab
AT iwasakiyoshinobu idiopathichypereosinophilicsyndromeinremissionwithbenralizumabtreatmentafterrelapsewithmepolizumab