Número Atual:  Julho-Setembro 2021 - Volume 5  - Número 3

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  Autores
  • Ana Rita Presa
  • Cristina Lara Valente
  • Maria João Sousa
  • Dorinda Inês Lopes

Comunicações Clínicas e Experimentais

Mepolizumabe como terapêutica poupadora de esteroides num paciente com granulomatose eosinofílica com poliangiite

Mepolizumab as a steroid-sparing treatment option in a patient with eosinophilic granulomatosis with polyangiitis

Ana Rita Presa; Cristina Lara Valente; Maria João Sousa; Dorinda Inês Lopes

DOI: 10.5935/2526-5393.20210047

Centro Hospitalar Vila Nova de Gaia/Espinho, Departamento de Alergologia - Vila Nova de Gaia, Porto, Portugal

Endereço para correspondência:

Ana Rita Presa
E-mail: aritapresa@gmail.com

RESUMO

Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem disorder characterized by asthma, peripheral blood eosinophilia, and signs of vasculitis. Glucocorticoids are considered the cornerstone of treatment, but most patients remain steroid-dependent and carry a significant burden of adverse effects. We report a case of a patient with steroid-dependent EGPA successfully treated with mepolizumab. A 36-year-old man presented with persistent rhinitis, dyspnea, wheezing, and dry cough poorly controlled with inhaled therapy. Eosinophilia in peripheral blood and bronchoalveolar lavage fluid was seen. Histological findings from nasal mucosa revealed eosinophilic microabscesses and vasculitis without granulomas compatible with EGPA diagnosis. After daily oral prednisolone (PSL) was started, symptoms and eosinophilia improved, but adverse effects emerged. Attempts at tapering off PSL resulted in worsening of symptoms. He started mepolizumab 300 mg monthly, with clinical improvement and sustained disease remission, which allowed reducing the need for PSL. We present a very disabling steroid-dependent EGPA. Mepolizumab was able to taper off PSL while maintaining symptomatic control.

Descritores: Eosinophilic granulomatosis with polyangiitis, interleukin-5, mepolizumab.