Disappearance of angina attacks after administration of mepolizumab

A 75-year-old woman with bronchial asthma and angina presented with dyspnea. She was using nifedipine, nitroglycerin, pranlukast and salmeterol plus fluticasone propionate inhalations. We diagnosed her with severe bronchial asthma. Oral steroids prescribed for the asthma symptoms had only temporary effects. Therefore, we additionally prescribed mepolizumab; the bronchial asthma improved and the angina attacks disappeared. However, after the patient discontinued treatment, the bronchial asthma and angina attacks recurred, which were treated with nitroglycerin. When she returned 12 weeks later, we resumed mepolizumab administration; the bronchial asthma improved and the angina attacks disappeared again. Hence, we concluded that her angina was due to eosinophilia since the angina attacks disappeared with the mepolizumab therapy. Despite limitations such as lack of arterial blood gas data, perfusion scan, gastrointestinal fiberscopy and Aspergillus skin and precipitation tests, we believe that this is the first report to suggest mepolizumab treatment for angina attacks.