Isolated CNS involvement in eosinophilic granulomatosis with polyangiitis treated with mepolizumab: A case report

Area of Science:

• Neurology
• Immunology
• Rheumatology

Background:

• Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis affecting small vessels.
• Central nervous system (CNS) involvement in EGPA is uncommon, with isolated CNS EGPA being extremely rare.
• Standardized treatment for isolated CNS EGPA remains unclear due to limited clinical data.

Observation:

• This report describes a unique case of EGPA presenting solely with CNS involvement.
• Diagnosis was confirmed through brain biopsy.
• The patient's condition was refractory to conventional immunotherapy.

Findings:

• Mepolizumab, an anti-interleukin-5 monoclonal antibody, was administered to the patient.
• Mepolizumab demonstrated efficacy in treating this refractory case of isolated CNS EGPA.
• This suggests a potential therapeutic role for mepolizumab in such rare presentations.

Implications:

• This case highlights mepolizumab as a viable treatment option for refractory isolated CNS EGPA.
• Further research into targeted therapies like mepolizumab is warranted for rare vasculitic presentations.
• Understanding treatment responses in rare EGPA subtypes can improve patient outcomes.