Case Report: From misdiagnosis to successful treatment using mepolizumab in ANCA-negative severe EGPA—clinical lessons in eosinophil-targeted therapy - Summary - MDSpire
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Case Report: From misdiagnosis to successful treatment using mepolizumab in ANCA-negative severe EGPA—clinical lessons in eosinophil-targeted therapy
To present the diagnostic and treatment journey of a patient with ANCA-negative eosinophilic granulomatosis with polyangiitis (EGPA) and evaluate the effectiveness of mepolizumab.
Approach:
Case Report: A 33-year-old female patient with a history of asthma and chronic rhinosinusitis was diagnosed with severe EGPA after experiencing multi-organ involvement. Treatment with mepolizumab was initiated after discontinuation of omalizumab.
Key Findings:
Mepolizumab (300 mg every 4 weeks) led to symptom resolution and allowed for glucocorticoid tapering.
The patient was diagnosed with severe EGPA after a complex clinical course, including myocarditis and eosinophilia.
Mepolizumab dosing interval was successfully extended to 8 weeks while maintaining remission.
Interpretation:
Limitations:
The application experience of mepolizumab in ANCA-negative severe EGPA remains limited.
The case report is based on a single patient, limiting generalizability.
Conclusion:
The case highlights the importance of careful evaluation for EGPA in patients with asthma before initiating biologic therapy.
