Hattori Keita, Teramachi Yuri, Kobayashi Yoshinori, Ito Takeshi, Morinaga Takatoshi, Tamai Hirohumi, Yamamoto Yoshihiro
Division of Nephrology, Department of Internal Medicine, Anjo Kosei Hospital, Anjo, Japan.
Division of Nephrology, Department of Internal Medicine, Toyota Memorial Hospital, Toyota, Japan.
Case Rep Rheumatol. 2021 Jun 19;2021:6678893. doi: 10.1155/2021/6678893. eCollection 2021.
A 66-year-old man with a history of bronchial asthma and sinusitis was admitted with cholecystitis and peripheral neuropathy. The histopathological findings of the gallbladder revealed necrotic vasculitis and granulomatous inflammation with marked eosinophilic infiltration. Kidney biopsy also showed marked eosinophilic infiltration in the tubulointerstitial area and eosinophilic tubulitis. He was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA) and treated with corticosteroids. However, he showed no response. Therefore, he was administered mepolizumab 300 mg, which resulted in clinical improvement, including normalization of the eosinophil and CRP levels. We herein describe the first case of successful induction therapy of EGPA using mepolizumab.
一名66岁男性，有支气管哮喘和鼻窦炎病史，因胆囊炎和周围神经病变入院。胆囊组织病理学检查发现坏死性血管炎和肉芽肿性炎症，伴有明显的嗜酸性粒细胞浸润。肾活检也显示肾小管间质区域有明显的嗜酸性粒细胞浸润和嗜酸性肾小管炎。他被诊断为嗜酸性肉芽肿性多血管炎（EGPA）并接受了皮质类固醇治疗。然而，他没有反应。因此，给他使用了300毫克的美泊利单抗，这导致了临床改善，包括嗜酸性粒细胞和CRP水平恢复正常。我们在此描述了首例使用美泊利单抗成功诱导治疗EGPA的病例。
