Omalizumab
- PDF / 158,465 Bytes
- 1 Pages / 623.591 x 841.847 pts Page_size
- 67 Downloads / 171 Views
1
S
Churg-Strauss syndrome in a patient following a reduction in corticosteroid dosage?: case report A 62-year-old man developed Churg-Strauss syndrome during treatment with omalizumab [duration of therapy to reaction onset not stated]; following omalizumab initiation, prednisolone had been discontinued and his fluticasone dosage had been reduced. In January 2006, the man, who had chronic sinusitis and persistent allergic asthma and was receiving prednisolone, fluticasone and salmeterol, started receiving omalizumab 150 mg/month. Within 4 months, his asthma symptoms were optimally controlled and prednisolone was discontinued and his fluticasone dosage was reduced. In December 2006, he presented with a weight loss of 12kg, a temperature up to 39°C and asthenia. He had a progressive massive infiltration of his sinuses and left cheek, followed by a subocclusive syndrome. Examination showed a hypogastric tumour. An abdominal MRI showed an extensive mesenteric infiltration and the presence of a massive infiltration of his left cheek and sinuses was confirmed by a cervical CT scan. Laboratory tests revealed a WBC count of 4.6 × 103/L with an eosinophil count of 2.07 × 103/L. Cheek and sinus biopsies demonstrated a massive eosinophilic infiltrate with a small granulomatous lesion, indicating vasculitis. Bronchi biopsies showed a moderate eosinophilic infiltrate. A myelography revealed an excess of eosinophils with 16% mature eosinophils, 11% myelocyte eosinophils and 6% metamyelocyte eosinophils. Findings were consistent with a diagnosis of Churg-Strauss syndrome. Omalizumab was discontinued and the man received highpulse methylprednisolone, followed by oral prednisone and cyclophosphamide. Within a week, his condition improved with resolution of his asthenia, fever and subocclusive syndrome; fibrotic infiltration of his left cheek persisted. Author comment: "[Two] main hypotheses could be considered. First, omalizumab could play a direct causative role in the development of [Churg Strauss syndrome], although there is no clear mechanistic connection yet. Second, reduction of corticosteroids, permitted by omalizumab, could reveal [Churg Strauss syndrome], which, beforehand, manifests itself only by asthma". Ruppert A-M, et al. Development of Churg-Strauss syndrome with controlled asthma during omalizumab treatment. Journal of Allergy and Clinical Immunology 801079827 121: 253-254, No. 1, Jan 2008 - France
» Editorial comment: This case report has been previously reported and summarised from an abstract [see Reactions 1177 p21; 801083976]
0114-9954/10/1186-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 26 Jan 2008 No. 1186
Data Loading...
