Anti-IL-5 Agents for the Treatment of Idiopathic Chronic Eosinophilic Pneumonia: A Case Series

Figures & data

Table 1 Clinical Characteristics of Patients with Idiopathic Chronic Eosinophilic Pneumonia (n = 30)

Age (years)	60.9 ± 16.4
Gender (male/female)	12/18
BMI (kg/m^2)	21.3 ± 3.7
Duration of observation (days)	1553.5 ± 1326.6
Comorbidities (%)
Hypertension	11 (36.6%)
Hyperlipidemia	5 (16.7%)
Diabetes	6 (20.0%)
Allergic comorbidities (%)
Asthma	9 (30.0%)
Allergic Rhinitis	5 (16.7%)
Symptoms (%)
Fever (>37.5°C)	13 (43.3%)
Cough	26 (86.7%)
Sputum	12 (40.0%)
Radiologic features on chest computed tomography (%)
Limited in one lobe	4 (13.3%)
Both lung fields	23 (76.7%)
Laboratory findings
White blood cell (/μL)	11,734.7 ± 6475.1
Eosinophil (%)	23.8 ± 16.3
Eosinophil count (/μL)	3392.2 ± 5023.3
C reactive protein (mg/dl)	5.2 ± 5.8
Eosinophil ratio on bronchoalveolar lavage (n = 22) (%)	50.9 ± 19.3
Initial corticosteroid dose converted to prednisolone (mg)	32.0 ± 14.7
Duration of the initial corticosteroid dose (days)	12.4 ± 6.8
Patients who experienced recurrence after corticosteroid tapering (%)	12 (40.0%)
Patients who were treated with maintenance dose of corticosteroid (%)	9 (30.0%)
Maintenance dose of corticosteroid converted to prednisolone (mg)	7.6 ± 5.7

Abbreviation: BMI, body mass index.

Table 2 Patients with ICEP Who Experienced Recurrence After Steroid Tapering (n = 12)

Duration from diagnosis to the first recurrence (days)	250.7 ± 168.7
Prednisolone dose at the time of recurrence (mg)	5.0 ± 4.2
Recurrence time (%)
1	6 (50.0%)
> or = to 2	6 (50.0%)
Laboratory findings at the time of recurrence
White blood cell (/μL)	10,764.2 ± 4637.7
Eosinophil (%)	15.6 ± 14.6
Eosinophil count (/μL)	1988.5 ± 2474.2
C reactive protein (mg/dl)	1.3 ± 1.4

Abbreviation: ICEP, idiopathic chronic eosinophilic pneumonia.

Table 3 Clinical Information of 4 ICEP Cases Treated by Anti-IL-5 Agents

	Age	Gender	Frequency of Recurrence	Blood Eosinophil (/μL)	BAL Eosinophil (%)	Prednisolone Dose at Recurrence (mg)	Anti-IL-5 Agents	Prednisolone Dose after Induction of Anti-IL-5 Agents (mg)
Case1	67	F	3	2990	40	5	Benralizumab	0
Case2	37	F	4	2853.1	50	12.5	Benralizumab	5
Case3	74	M	2	4939	n.e.	4	Mepolizumab	0
Case4	68	M	3	6068.2	n.e.	5	Mepolizumab	0

Abbreviations: ICEP, idiopathic chronic eosinophilic pneumonia; BAL, bronchoalveolar lavage; IL-5, interleukin 5; n.e, not examined.

Figure 1 Chest computed tomography (CT) with the lung window setting shows ground-glass shadows and infiltrations in bilateral central lung fields.

Figure 2 Chest CT with the lung window setting shows infiltrations in bilateral peripheral lung fields.

Figure 3 Chest CT with the lung window setting shows infiltrations in bilateral lung fields.

Figure 4 Chest CT with the lung window setting shows ground-glass shadows and infiltrations in bilateral lower lung fields.