Marked neurological and immunological improvement in refractory eosinophilic granulomatous polyangiitis after treatment with mepolizumab, an anti‐interleukin‐5 antibody: A case report

Abstract

AbstractBackgroundMepolizumab is an option for add‐on therapy in cases of refractory or relapsing eosinophilic granulomatous polyangiitis (EGPA). However, it has not been fully investigated if add‐on mepolizumab is effective for active refractory or active relapsing EGPA patients with life‐ and/or organ‐threatening manifestations, especially with severe neuropathy.Case presentationWe herein report on a 63‐year‐old man with severe progressive neuropathy secondary to active relapsing EGPA. In this case, the optimal dose of glucocorticoids and cyclophosphamide could not be used because of glaucoma and signet ring cell carcinoma. Add‐on therapy of mepolizumab showed prompt immunological remission and marked improvement in neurological manifestations.ConclusionsMepolizumab can be considered as an important induction therapy option for active relapsing or refractory EGPA. It has the potential to effectively improve neurological disturbances associated with severe neuropathy in EGPA.