Open AccessEffectiveness of mepolizumab for eosinophilic pneumonia following bronchial thermoplasty
Author(s) -
Otoshi Ryota,
Baba Tomohisa,
Komatsu Shigeru,
Asaoka Masato,
Hagiwara Eri,
Ogura Takashi
Publication year - 2020
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.514
Subject(s) - mepolizumab , bronchial thermoplasty , medicine , eosinophilic pneumonia , bronchoalveolar lavage , pneumonia , asthma , eosinophilic , high resolution computed tomography , gastroenterology , lung , pathology , eosinophil , bronchoconstriction
A 57‐year‐old woman with poorly controlled diabetes was admitted to our hospital for additional treatment of severe asthma. Although bronchial thermoplasty was performed in the both upper lobes, cough and dyspnoea gradually appeared 2 weeks later. High‐resolution computed tomography revealed thickness of intralobular septa and a diffuse ground‐glass attenuation in the lung fields. Laboratory examination revealed elevated levels of serum eosinophils and total immunoglobulin E. Bronchoalveolar lavage fluid showed a remarkable increase of eosinophils as high as 48.5%, then eosinophilic pneumonia was diagnosed. Although treatment with steroids resulted in an improvement of eosinophilic pneumonia, the treatment was discontinued after 4 days because it worsened her diabetic condition. Since eosinophilic pneumonia recurred after discontinuing steroid, mepolizumab was administered, which subsequently improved her disease condition. Clinicians should be aware that bronchial thermoplasty can lead to eosinophilic pneumonia and mepolizumab might be an effective treatment in this setting.