Shimizu Hideyasu, Kato Hisayuki, Yoshioka Satoshi, Okazawa Mitsushi
Toshiwakai Clinic, Nagoya Japan, Nagoya, Japan.
Department of Medicine, Division of Respiratory Medicine and Clinical Allergy, Fujita Health University, Toyoake, Japan.
Respir Med Case Rep. 2020 Dec 31;32:101336. doi: 10.1016/j.rmcr.2020.101336. eCollection 2021.
Severe bronchial asthma is a challenging disorder to treat and can impair quality of life (QOL) under conventional therapeutic modalities. We report the case of a 52-year-old woman with severe asthma associated with eosinophilic chronic rhinosinusitis (ECRS) and eosinophilic otitis media (EOM). Although the patient was treated with a full dose of inhaled corticosteroid, leukotriene receptor antagonist (LTRA), theophylline, burst use of oral corticosteroids (OCS), her asthmatic condition aggravated, disrupting her daily life. ECRS and EOM symptoms were also getting worse despite treatment with topical application of corticosteroids to the nose and ears, LTRA, and occasional use of OCS. In addition to asthmatic symptom, the patient always suffered from intractable nasal obstruction and hearing disturbance, which contributed to the heavily impaired QOL. However, the administration of benralizumab showed rapid and remarkable improvement not only in her asthmatic conditions but also in the symptoms of ECRS and EOM within a month. These results suggest that the use of benralizumab for the treatment of severe asthma with intractable ECRS and EOM should be considered when the patient's QOL is severely deteriorated.
重度支气管哮喘是一种难以治疗的疾病,在传统治疗方式下会损害生活质量(QOL)。我们报告了一例52岁女性患者,患有重度哮喘,伴有嗜酸性粒细胞性慢性鼻-鼻窦炎(ECRS)和嗜酸性粒细胞性中耳炎(EOM)。尽管该患者接受了全剂量吸入性糖皮质激素、白三烯受体拮抗剂(LTRA)、茶碱治疗,以及口服糖皮质激素(OCS)的突击使用,但其哮喘病情仍加重,扰乱了她的日常生活。尽管对鼻子和耳朵局部应用糖皮质激素、LTRA,并偶尔使用OCS进行治疗,ECRS和EOM症状仍在恶化。除了哮喘症状外,患者还一直患有顽固性鼻塞和听力障碍,这严重损害了生活质量。然而,使用贝那利珠单抗治疗后,不仅患者的哮喘病情在一个月内迅速且显著改善,ECRS和EOM症状也有所改善。这些结果表明,当患者生活质量严重恶化时,应考虑使用贝那利珠单抗治疗伴有顽固性ECRS和EOM的重度哮喘。