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Marked neurological and immunological improvement in refractory eosinophilic granulomatous polyangiitis after treatment with mepolizumab, an anti‐interleukin‐5 antibody: A case report
Author(s) -
Yasuda Manato,
Sugiyama Atsuhiko,
Suichi Tomoki,
Misawa Sonoko,
Kuwabara Satoshi
Publication year - 2020
Publication title -
clinical and experimental neuroimmunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.297
H-Index - 15
ISSN - 1759-1961
DOI - 10.1111/cen3.12582
Subject(s) - mepolizumab , medicine , granulomatosis with polyangiitis , refractory (planetary science) , eosinophilic , mononeuritis multiplex , dermatology , immunology , pathology , vasculitis , eosinophil , asthma , physics , disease , astrobiology
Abstract Background Mepolizumab is an option for add‐on therapy in cases of refractory or relapsing eosinophilic granulomatous polyangiitis (EGPA). However, it has not been fully investigated if add‐on mepolizumab is effective for active refractory or active relapsing EGPA patients with life‐ and/or organ‐threatening manifestations, especially with severe neuropathy. Case presentation We herein report on a 63‐year‐old man with severe progressive neuropathy secondary to active relapsing EGPA. In this case, the optimal dose of glucocorticoids and cyclophosphamide could not be used because of glaucoma and signet ring cell carcinoma. Add‐on therapy of mepolizumab showed prompt immunological remission and marked improvement in neurological manifestations. Conclusions Mepolizumab can be considered as an important induction therapy option for active relapsing or refractory EGPA. It has the potential to effectively improve neurological disturbances associated with severe neuropathy in EGPA.