Advanced search
Publication Cover
Journal of Asthma Volume 59, 2022 - Issue 12
Submit an article Journal homepage
311
Views
6
CrossRef citations to date
0
Altmetric
Pharmacotherapy

Dupilumab as an adjunct treatment for a patient with steroid-dependent immunoglobulin G4-related disease complicated by asthma: a case report

Toshihito Otani,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD,
Hiroshi Iwamoto,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0003-4922-5334
, MD, PhDORCID Icon,
Yusuke Yoshida,b Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, JapanORCID Iconhttps://orcid.org/0000-0002-0774-0509
, MD, PhDORCID Icon,
Kakuhiro Yamaguchi,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Shinjiro Sakamoto,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Yasushi Horimasu,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Takeshi Masuda,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Shintaro Miyamoto,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Taku Nakashima,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Kazunori Fujitaka,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Hironobu Hamada,c Department of Physical Analysis and Therapeutic Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD,
Shintaro Hirata,b Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, JapanORCID Iconhttps://orcid.org/0000-0002-2474-9943
, MD, PhDORCID Icon,
Eiji Sugiyama,d Department of Internal Medicine, Yoshida General Hospital, Akitakata, JapanORCID Iconhttps://orcid.org/0000-0001-8534-6729
, MD, PhDORCID Icon &
Noboru Hattori,a Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
, MD, PhD show all
Pages 2395-2401 | Received 18 Sep 2021, Accepted 20 Dec 2021, Published online: 31 Dec 2021
 
Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days

Abstract

Introduction: Immunoglobulin G4-related disease (IgG4-RD) responds well to glucocorticoids but is often associated with relapses. Interleukin (IL)-4 and IL-13 are involved in the pathogenesis of IgG4-RD. We present the first case in which dupilumab was an effective adjunct treatment for a patient with steroid-dependent IgG4-RD complicated by asthma.Case study: A 57-year-old man was referred to our hospital for further investigation and treatment of proptosis with neck swelling in 2019. He developed a cough and swelling of the neck in 2016. He was diagnosed with asthma in 2017 and started receiving inhaled glucocorticoids and a long-acting beta-agonist. The patient started receiving oral prednisolone at a dose of 20 mg/day. Oral prednisolone reduced his symptoms, but he relapsed when treatment was tapered to less than 10 mg/day. He was diagnosed with IgG4-RD through a parotid gland biopsy.Results: Azathioprine was given to reduce systemic glucocorticoids. The prednisolone dose was gradually tapered to 10 mg/day, resulting in the relapse of proptosis and an asthma attack. We added dupilumab, and his asthma symptoms and proptosis improved. Serum IgG4 levels continued to decrease, and the prednisolone dose was tapered to 2 mg.Conclusion: Dupilumab might be useful as an adjunctive treatment for patients with steroid-dependent IgG4-RD complicated by asthma. Serum IgG4 levels can be used as a marker to monitor dupilumab treatment in IgG4-RD.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

No funding was received for the preparation of this case report.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Log in via your institution

Access through your institution

Log in to Taylor & Francis Online

Restore content access

Restore content access for purchases made as guest
Purchase options * Save for later

PDF download + Online access

  • 48 hours access to article PDF & online version
  • Article PDF can be downloaded
  • Article PDF can be printed
USD 65.00 Add to cart

Issue Purchase

  • 30 days online access to complete issue
  • Article PDFs can be downloaded
  • Article PDFs can be printed
USD 1,078.00 Add to cart

* Local tax will be added as applicable

Related Research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.