Successful treatment of eosinophilic granulomatosis with polyangiitis (EGPA; formerly Churg–Strauss syndrome) with rituximab in a case refractory to glucocorticoids, cyclophosphamide, and IVIG

Natsuka UmezawaDepartment of Medicine and Rheumatology, Graduate School of Medicine and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan

Hitoshi KohsakaDepartment of Medicine and Rheumatology, Graduate School of Medicine and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan

Toshihiro NankiDepartment of Medicine and Rheumatology, Graduate School of Medicine and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan;Department of Pharmacovigilance, Tokyo Medical and Dental University, Tokyo, Japan

Kaori WatanabeDepartment of Medicine and Rheumatology, Graduate School of Medicine and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan;Department of Pharmacovigilance, Tokyo Medical and Dental University, Tokyo, Japan

Michi TanakaDepartment of Medicine and Rheumatology, Graduate School of Medicine and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan;Department of Pharmacovigilance, Tokyo Medical and Dental University, Tokyo, Japan

Peter Y. ShaneDepartment of Medicine and Rheumatology, Graduate School of Medicine and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan

Nobuyuki MiyasakaDepartment of Medicine and Rheumatology, Graduate School of Medicine and Dental Science, Tokyo Medical and Dental University, Tokyo, JapanCorrespondence[email protected]

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Abstract

A 44-year old woman with eosinophilic granulomatosis with polyangiitis (EGPA) developed sequential paralysis of different cranial nerves despite treatments including methylpredonisolone pulse therapy, intravenous immunoglobulins (IVIG), and cyclophosphamide. Infusions of rituximab ameliorated her neurological symptoms and serological inflammatory findings. Rituximab, a specific B cell-targeting therapy, might offer an alternative for refractory EGPA with possible advantages of cost and ease of use compared to IVIG, which also targets (at least in part) B lymphocytes and immunoglobulin production.

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Conflict of interest

PYS is currently employed by UCB Japan, Co., Ltd. All other authors have declared no conflict of interest.

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Successful treatment of eosinophilic granulomatosis with polyangiitis (EGPA; formerly Churg–Strauss syndrome) with rituximab in a case refractory to glucocorticoids, cyclophosphamide, and IVIG

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Successful treatment of eosinophilic granulomatosis with polyangiitis (EGPA; formerly Churg–Strauss syndrome) with rituximab in a case refractory to glucocorticoids, cyclophosphamide, and IVIG

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