eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
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3/2021
vol. 46
 
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abstract:
Case report

Severe hypereosinophilic syndrome successfully treated with a monoclonal antibody against interleukin 5 receptor α – benralizumab

Joanna Kosałka-Węgiel
1, 2
,
Mamert Milewski
2
,
Andżelika Siwiec
1, 2
,
Magdalena Strach
1
,
Bogdan Ochrem
3
,
Mariusz Korkosz
1

1.
Department of Rheumatology and Immunology, Jagiellonian University Medical College, Kraków, Poland
2.
2nd Department of Internal Medicine, University Hospital, Kraków, Poland
3.
Department of Hematology, University Hospital, Kraków, Poland
Cent Eur J Immunol 2021; 46 (3): 395-397
Online publish date: 2021/08/03
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Introduction
Hypereosinophilic syndrome (HES) is a group of a rare diseases characterized by marked eosinophilia in blood or tissue and eosinophil-related clinical manifestations. Benralizumab is a humanized, monoclonal antibody against interleukin 5 (IL-5) receptor a, which is expressed on human eosinophils.

Case study
Here, we present the case of a patient with severe HES in whom treatment with benralizumab, an anti-IL-5 receptor monoclonal antibody, was initiated 6 months ago. Prior to benralizumab administration, the patient was treated with glucocorticoids (GS) and mepolizumab. However, instead of the applied treatment and normal level of peripheral eosinophils the patient presented with fluctuating lower respiratory tract symptoms and recurrent exacerbations of HES.

Results
Treatment with benralizumab (30 mg s.c. every 4-6 weeks) was started, resulting in significant improvement of respiratory signs and symptoms, normalization of eosinophil count and significant reduction of the methylprednisolone dose (after 5 doses of benralizumab administration). No substantial side effects have been noted during treatment and 6-month follow-up.

Conclusions
We argue that in the severe and relapsing course of HES, rescue treatment with benralizumab should be taken into account, particularly in cases of relative inefficacy of GS and mepolizumab.

keywords:

hypereosinophilic syndrome, HES, benralizumab, IL-5, IL-5 receptor, monoclonal antibody

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