A Case of Eosinophilic Pneumonia in a Patient Receiving Dupilumab Therapy

• Published in: The Journal of the Japan Society for Respiratory Endoscopy Vol. 44; no. 5; pp. 377 - 382
• Main Authors: Nishida, Kohei, Nagai, Takaaki, Toda, Shiori, Inazu, Satsuki, Takagi, Yasuhiro, Tamagaki, Gakuya, Fujii, Tatsuo
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society for Respiratory Endoscopy 25.09.2022
• Subjects: Bronchial asthma; Bronchoalveolar lavage; Dupilumab; Eosinophilic pneumonia; Eosinophils
• ISSN: 0287-2137; 2186-0149
• DOI: 10.18907/jjsre.44.5_377

Background. Dupilumab is a humanized monoclonal antibody that inhibits the interleukin-4 receptor alpha chain. It is widely used to treat atopic dermatitis, bronchial asthma, and chronic sinusitis with nasal polyps. Case. A 72-year-old woman presented to our hospital with cough, dyspnea, and loss of appetite that had persisted for approximately 7 months after commencing dupilumab therapy for chronic sinusitis with nasal polyps. Antibiotics therapy for bacterial pneumonia was initiated since she had an inflammatory response and consolidation was observed in the lung field on chest computed tomography; however, the antibiotics were ineffective. The eosinophil ratio in the bronchoalveolar lavage fluid was 76%; hence, she was diagnosed with eosinophilic pneumonia. Dupilumab was considered to have triggered the onset of eosinophilic pneumonia. Her symptoms improved following the discontinuation of dupilumab and the initiation of steroid therapy. Conclusion. It is necessary to pay attention to the underlying disease condition and the possible onset of eosinophilic pneumonia during dupilumab therapy.