Wu Jiajun, Li Linlin, Ten Weidong, Wang Yuchen, Liu Ruiqi, Hu Binbin, Tan Jun, Dong Feilin, Shi Kaiwen, Zhang Haibo, Su Lizhong, Hu Weiming
Otolaryngology & Head and Neck Center, Cancer Center, Department of Otolaryngology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.
Zhejiang Provincial Clinical Research Center for Head & Neck Cancer, Hangzhou, 310014, China.
J Clin Immunol. 2025 Jul 24;45(1):114. doi: 10.1007/s10875-025-01914-x.
Eosinophilic Granulomatosis with Polyangiitis (EGPA) is a rare vasculitis characterized by increased eosinophils in human tissues and peripheral blood. In this case, we present a 53-year-old female patient with EGPA. By this case and literature review, we want to explain the early manifestations, diagnosis, and management of EGPA, which will help clinicians to understand the disease and attach importance to the possibility of dupilumab-induced EGPA, to improve the early diagnosis rate of EGPA, and reduce misdiagnosis and missed diagnosis.
The diagnostic criteria for EGPA established by the American Rheumatology Association (ACR) in 2022 were used; these criteria encompass clinical presentation, laboratory tests, and pathological biopsy. In addition, we conducted a comprehensive literature review on this case.
We present a 53-year-old female patient who developed severe peripheral neuropathic pain after the administration of dupilumab for the treatment of refractory asthma and sinusitis. The patient's symptoms, laboratory examination findings, and nasopharyngeal biopsy pathology results collectively support the diagnosis of EGPA. When dupilumab was converted to mepolizumab combined with glucocorticoid, her peripheral neuropathic pain and asthma symptoms were dramatically relieved. Our literature review also provides a detailed discussion on the relationship between Dupilumab and EGPA.
We present a case of EGPA with peripheral neuropathic pain induced by Dupilumab, and mepolizumab has a good therapeutic effect on this patient. Our literature review shows that although dupilumab is effective in treating eosinophilic airway inflammatory diseases, clinicians must pay attention to the possibility of dupilumab inducing or aggravating EGPAs.
嗜酸性肉芽肿性多血管炎（EGPA）是一种罕见的血管炎，其特征是人体组织和外周血中嗜酸性粒细胞增多。在此病例中，我们报告一名53岁的EGPA女性患者。通过该病例及文献回顾，我们旨在阐述EGPA的早期表现、诊断及治疗，这将有助于临床医生了解该疾病，并重视度普利尤单抗诱导EGPA的可能性，提高EGPA的早期诊断率，减少误诊和漏诊。
采用美国风湿病学会（ACR）2022年制定的EGPA诊断标准，该标准涵盖临床表现、实验室检查及病理活检。此外，我们对该病例进行了全面的文献回顾。
我们报告一名53岁女性患者，在使用度普利尤单抗治疗难治性哮喘和鼻窦炎后出现严重的外周神经病理性疼痛。患者的症状、实验室检查结果及鼻咽活检病理结果共同支持EGPA的诊断。当将度普利尤单抗换为美泊利单抗联合糖皮质激素治疗后，其外周神经病理性疼痛和哮喘症状明显缓解。我们的文献回顾还对度普利尤单抗与EGPA之间的关系进行了详细讨论。
我们报告了一例由度普利尤单抗诱发外周神经病理性疼痛的EGPA病例，美泊利单抗对该患者有良好的治疗效果。我们的文献回顾表明，尽管度普利尤单抗在治疗嗜酸性气道炎症性疾病方面有效，但临床医生必须注意度普利尤单抗诱发或加重EGPA的可能性。
