Hamakawa Masamitsu, Tanaka Ayaka, Tokioka Fumiaki, Ishida Tadashi
Department of Respiratory Medicine Kurashiki Central Hospital Okayama Japan.
Respirol Case Rep. 2024 Jun 13;12(6):e01412. doi: 10.1002/rcr2.1412. eCollection 2024 Jun.
Several reports have described dupilumab-induced eosinophilic pneumonia (EP) after treatment with dupilumab in patients with type 2 inflammatory disease. Other reports have suggested the efficacy of dupilumab for chronic EP (CEP). Whether dupilumab can be continued in patients with type 2 inflammatory disease who develop EP during dupilumab treatment remains unclear. We present herein three cases with different clinical presentations involving dupilumab and EP. In Case 1, dupilumab was discontinued because of dupilumab-induced EP during the treatment of asthma. In Case 2, although pre-existing idiopathic EP worsened during the treatment of eosinophilic chronic rhinosinusitis (ECRS), dupilumab was continued. In Case 3, CEP and ECRS were successfully treated with dupilumab and corticosteroids were discontinued. In conclusion, treatment with dupilumab in patients with type 2 inflammatory disease and idiopathic EP is worth considering if the benefits are deemed to outweigh the risks and careful attention is given to the clinical course.
有几份报告描述了2型炎症性疾病患者使用度普利尤单抗治疗后出现的度普利尤单抗诱导的嗜酸性粒细胞性肺炎（EP）。其他报告表明度普利尤单抗对慢性EP（CEP）有效。在度普利尤单抗治疗期间发生EP的2型炎症性疾病患者是否可以继续使用度普利尤单抗仍不清楚。我们在此介绍三例涉及度普利尤单抗和EP的不同临床表现的病例。病例1中，在哮喘治疗期间因度普利尤单抗诱导的EP而停用了度普利尤单抗。病例2中，尽管在嗜酸性粒细胞性慢性鼻-鼻窦炎（ECRS）治疗期间既往存在的特发性EP恶化，但仍继续使用度普利尤单抗。病例3中，CEP和ECRS通过度普利尤单抗成功治疗，停用了皮质类固醇。总之，如果认为益处大于风险且密切关注临床过程，2型炎症性疾病和特发性EP患者使用度普利尤单抗治疗是值得考虑的。
