Sugiyama Tomonori, Yoshida Saeko, Kikuchi Saori, Iino Yukiko
Department of Otolaryngology, Tokyo-kita Medical Center.
Arerugi. 2022;71(3):242-247. doi: 10.15036/arerugi.71.242.
Eosinophilic granulomatosis with polyangiitis (EGPA) is a type of ANCA-related vasculitis. Asthma and sinusitis occur first in the course of EGPA, followed by vasculitis symptoms such as fever, weight loss, and peripheral neuropathy. Otitis media with effusion and sensorineural hearing loss occur occasionally in EGPA patients. Here we report a case of a 39-years-old female patient with asthma that developed at age 37 and sinusitis. The patient was diagnosed with EGPA and treatment was started with oral corticosteroids. During the course of treatment, otitis media with effusion and sensorineural hearing loss developed. Benralizumab was administered for severe asthma. After treatment with benralizumab, the symptoms of asthma, otitis media with effusion and sinusitis dramatically improved. This is the first reported case in which benralizumab was used for treating otitis media and sinusitis associated with EGPA. The findings suggest that benralizumab may be effective for otitis media and sinusitis associated with EGPA.
嗜酸性肉芽肿性多血管炎(EGPA)是一种抗中性粒细胞胞浆抗体(ANCA)相关性血管炎。哮喘和鼻窦炎在EGPA病程中首先出现,随后出现血管炎症状,如发热、体重减轻和周围神经病变。EGPA患者偶尔会发生分泌性中耳炎和感音神经性听力损失。在此,我们报告一例39岁女性患者,其在37岁时患哮喘和鼻窦炎。该患者被诊断为EGPA,并开始口服糖皮质激素治疗。在治疗过程中,出现了分泌性中耳炎和感音神经性听力损失。使用贝那利珠单抗治疗重度哮喘。使用贝那利珠单抗治疗后,哮喘、分泌性中耳炎和鼻窦炎症状显著改善。这是首例报道使用贝那利珠单抗治疗与EGPA相关的中耳炎和鼻窦炎的病例。这些发现提示贝那利珠单抗可能对与EGPA相关的中耳炎和鼻窦炎有效。