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Eosinophilic cystitis refractory to steroids successfully treated with benralizumab: A case report

We report a case of a 66-year-old male diagnosed with refractory to oral corticosteroids eosinophilic cystitis (EoC). Hematuria was the first and only sign of the disease that was otherwise asymptomatic, and the only abnormal lab finding he had was peripheral eosinophilia (700 cells/μl). Due to card...

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Autores principales: Konstantinou, George N., Voukelatou, Vasiliki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871778/
https://www.ncbi.nlm.nih.gov/pubmed/36704755
http://dx.doi.org/10.3389/falgy.2022.1055129
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author Konstantinou, George N.
Voukelatou, Vasiliki
author_facet Konstantinou, George N.
Voukelatou, Vasiliki
author_sort Konstantinou, George N.
collection PubMed
description We report a case of a 66-year-old male diagnosed with refractory to oral corticosteroids eosinophilic cystitis (EoC). Hematuria was the first and only sign of the disease that was otherwise asymptomatic, and the only abnormal lab finding he had was peripheral eosinophilia (700 cells/μl). Due to cardiovascular issues, an invasive surgical procedure was declined. As an alternative, benralizumab, an anti-IL-5Rα monoclonal antibody with anti-eosinophilic properties, was administered. The patient responded rapidly with clinical and histological complete remission of the EoC four months after benralizumab started. He continued benralizumab 30 mg Q4-weeks for 12 months without experiencing any side effects. Six months after the last dose, he is completely healthy with no peripheral eosinophilia. EoC is a rare condition with no standardized treatment. Those with corticosteroid-refractory EoC are eligible for surgery. Benralizumab has an excellent safety profile; therefore, it should be considered before deciding on invasive surgical procedures in selected, refractory to non-specific treatment cases, especially with EoC of unclear etiology. It is unclear if benralizumab may immunomodulate the unknown underlying mechanisms of EoC, considering that EoC did not relapse after benralizumab was deemed eliminated. Further studies are needed to investigate this possibility.
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spelling pubmed-98717782023-01-25 Eosinophilic cystitis refractory to steroids successfully treated with benralizumab: A case report Konstantinou, George N. Voukelatou, Vasiliki Front Allergy Allergy We report a case of a 66-year-old male diagnosed with refractory to oral corticosteroids eosinophilic cystitis (EoC). Hematuria was the first and only sign of the disease that was otherwise asymptomatic, and the only abnormal lab finding he had was peripheral eosinophilia (700 cells/μl). Due to cardiovascular issues, an invasive surgical procedure was declined. As an alternative, benralizumab, an anti-IL-5Rα monoclonal antibody with anti-eosinophilic properties, was administered. The patient responded rapidly with clinical and histological complete remission of the EoC four months after benralizumab started. He continued benralizumab 30 mg Q4-weeks for 12 months without experiencing any side effects. Six months after the last dose, he is completely healthy with no peripheral eosinophilia. EoC is a rare condition with no standardized treatment. Those with corticosteroid-refractory EoC are eligible for surgery. Benralizumab has an excellent safety profile; therefore, it should be considered before deciding on invasive surgical procedures in selected, refractory to non-specific treatment cases, especially with EoC of unclear etiology. It is unclear if benralizumab may immunomodulate the unknown underlying mechanisms of EoC, considering that EoC did not relapse after benralizumab was deemed eliminated. Further studies are needed to investigate this possibility. Frontiers Media S.A. 2023-01-10 /pmc/articles/PMC9871778/ /pubmed/36704755 http://dx.doi.org/10.3389/falgy.2022.1055129 Text en © 2023 Konstantinou and Voukelatou. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Allergy
Konstantinou, George N.
Voukelatou, Vasiliki
Eosinophilic cystitis refractory to steroids successfully treated with benralizumab: A case report
title Eosinophilic cystitis refractory to steroids successfully treated with benralizumab: A case report
title_full Eosinophilic cystitis refractory to steroids successfully treated with benralizumab: A case report
title_fullStr Eosinophilic cystitis refractory to steroids successfully treated with benralizumab: A case report
title_full_unstemmed Eosinophilic cystitis refractory to steroids successfully treated with benralizumab: A case report
title_short Eosinophilic cystitis refractory to steroids successfully treated with benralizumab: A case report
title_sort eosinophilic cystitis refractory to steroids successfully treated with benralizumab: a case report
topic Allergy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871778/
https://www.ncbi.nlm.nih.gov/pubmed/36704755
http://dx.doi.org/10.3389/falgy.2022.1055129
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