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Eosinophilic bronchiolitis successfully treated with benralizumab.
Keishi Sugino1, Hirotaka Ono2, Akira Hebisawa3
1Department of Respiratory Medicine, Tsuboi Hospital, Koriyama, Japan ks115108@tsuboi-hp.or.jp.
BMJ Case Reports
|October 20, 2021
Summary
A case study reveals eosinophilic bronchiolitis with IgG4-positive plasma cells in a patient with severe asthma. Benralizumab therapy significantly improved her symptoms.
Area of Science:
- Pulmonology
- Immunology
Background:
- A 53-year-old woman with a 20-year history of bronchial asthma (BA) presented with persistent wet cough and dyspnea.
- Despite high-dose inhaled corticosteroid treatment, she experienced frequent BA exacerbations requiring oral corticosteroid bursts.
Observation:
- High-resolution CT showed diffuse centrilobular nodules, bronchial wall thickening, and ground-glass opacities.
- Lung biopsy revealed cellular bronchiolitis with plasma cell and eosinophil infiltration.
- Immunohistochemical staining confirmed numerous IgG4-positive plasma cells, exceeding 40% of IgG-positive cells.
Findings:
- The patient was diagnosed with eosinophilic bronchiolitis with marked IgG4-positive plasma cell infiltration, associated with bronchial asthma.
- Histopathological findings indicated a distinct inflammatory pattern within the bronchioles.
Implications:
- This case highlights a potential association between eosinophilic bronchiolitis, IgG4-related disease, and severe bronchial asthma.
- Successful treatment with benralizumab suggests its potential efficacy in managing this specific inflammatory airway condition.
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