Successful treatment of eosinophilic chronic rhinosinusitis and eosinophilic otitis media using the anti-IL-5 receptor monoclonal antibody benralizumab: A case report.

Anti-IL-5 receptor monoclonal antibody Asthma Benralizumab Eosinophilic chronic rhinosinusitis Eosinophilic otitis media

Journal

Respiratory medicine case reports
ISSN: 2213-0071
Titre abrégé: Respir Med Case Rep
Pays: England
ID NLM: 101604463

Informations de publication

Date de publication:
2020
Historique:
received: 29 04 2020
revised: 16 06 2020
accepted: 16 06 2020
entrez: 3 7 2020
pubmed: 3 7 2020
medline: 3 7 2020
Statut: epublish

Résumé

Eosinophilic chronic rhinosinusitis (ECRS) is characterized by the presence of nasal polyps, dominant ethmoid shadows in computed tomography (CT) scans, and elevated levels of eosinophil infiltration into the nasal polyps and peripheral blood. ECRS is often accompanied by severe asthma. The recent development of monoclonal antibody-based biologics, including benralizumab, has offered new therapeutic approaches for the treatment of asthma and allergic diseases. Asthma and ECRS are closely related; hence, benralizumab could provide clinical benefit in ECRS patients with severe asthma. Herein, we report a case of a 47-year-old female patient with severe asthma that presented with nasal obstruction and hearing impairment. Nasal endoscopic and otoscopic examinations indicated the presence of bilateral nasal polyps in the middle nasal meatus, as well as a bilateral effusion in the tympanic cavity. Sinus and temporal CT images showed dominant ethmoid sinus and tympanic cavity shadows. Biopsy of nasal polyps revealed high numbers of eosinophils, which led to the diagnosis of ECRS; eosinophilic otitis media (EOM) with hypereosinophilia was also suspected. Treatment with benralizumab reduced the number of peripheral blood eosinophils and improved asthma symptoms. Prolonged benralizumab administration also resulted in a remarkable size reduction in bilateral middle nasal polyps and aeration of the tympanic cavity. In conclusion, benralizumab treatment improved the symptoms of severe asthma, ECRS, and EOM. Eosinophil depletion could be an important mechanism by which benralizumab improves ECRS and EOM. The use of benralizumab for the treatment of ECRS and EOM patients with severe asthma merits further investigation in large-cohort studies.

Identifiants

pubmed: 32612919
doi: 10.1016/j.rmcr.2020.101135
pii: S2213-0071(20)30192-1
pii: 101135
pmc: PMC7322358
doi:

Types de publication

Case Reports

Langues

eng

Pagination

101135

Informations de copyright

© 2020 The Authors.

Déclaration de conflit d'intérêts

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Auteurs

Hiroki Kagoshima (H)

Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Ryusuke Hori (R)

Department of Otolaryngology, Tenri Hospital, Nara, Japan.

Tsuyoshi Kojima (T)

Department of Otolaryngology, Tenri Hospital, Nara, Japan.

Yusuke Okanoue (Y)

Department of Otolaryngology, Tenri Hospital, Nara, Japan.

Atsushi Taguchi (A)

Department of Otolaryngology-Head & Neck Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan.

Hirotaka Yamamoto (H)

Department of Otolaryngology, Tenri Hospital, Nara, Japan.

Koki Hasebe (K)

Department of Otolaryngology, Tenri Hospital, Nara, Japan.

Kazuhiko Shoji (K)

Department of Otolaryngology, Tenri Hospital, Nara, Japan.

Classifications MeSH