Severe Asthma Where Eosinophilic Granulomatosis with Polyangiitis Became Apparent after the Discontinuation of Dupilumab

Miki Ikeda; Nobuharu Ohshima; Masahiro Kawashima; Meiko Shiina; Masashi Kitani; Maho Suzukawa

doi:10.2169/internalmedicine.7990-21

Severe Asthma Where Eosinophilic Granulomatosis with Polyangiitis Became Apparent after the Discontinuation of Dupilumab

Intern Med. 2022 Mar 1;61(5):755-759. doi: 10.2169/internalmedicine.7990-21. Epub 2021 Aug 13.

Authors

Miki Ikeda¹, Nobuharu Ohshima¹, Masahiro Kawashima¹, Meiko Shiina², Masashi Kitani³, Maho Suzukawa¹

Affiliations

¹ Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan.
² Department of Neurology, National Hospital Organization Tokyo National Hospital, Japan.
³ Department of Pathology, National Hospital Organization Tokyo National Hospital, Japan.

Abstract

The use of biologic agents has enabled control of severe asthma, but there is a risk that eosinophilic granulomatosis with polyangiitis (EGPA) may be masked in some cases. We herein report a 71-year-old man who was administered dupilumab for 2 years to stabilize his asthma symptoms. A few months after discontinuation of dupilumab administration, an increase in the eosinophil count in peripheral blood, leg pain, and a rash appeared. Based on pathology, he was diagnosed with EGPA. EGPA in this case was considered to have become apparent due to the discontinuation of dupilumab administration.

Keywords: dupilumab; eosinophilia; eosinophilic granulomatosis with polyangiitis; severe asthma.

Publication types

Case Reports

MeSH terms

Aged
Antibodies, Monoclonal, Humanized / adverse effects
Asthma* / diagnosis
Asthma* / drug therapy
Churg-Strauss Syndrome* / diagnosis
Churg-Strauss Syndrome* / drug therapy
Granulomatosis with Polyangiitis* / diagnosis
Granulomatosis with Polyangiitis* / drug therapy
Humans
Male

Substances

Antibodies, Monoclonal, Humanized
dupilumab