The Effectiveness of Dupilumab in Treating Pediatric Refractory Allergic Fungal Rhinosinusitis

Allergic fungal rhinosinusitis (AFRS) is defined as a benign, extramucosal, non-invasive fungal condition of the paranasal sinuses, resulting from a type 1 IgE-mediated hypersensitivity reaction. AFRS is most commonly seen in young adults, although it also occurs in the pediatric population. Currently, biological therapy has been proposed as an effective treatment for adult patients with AFRS. However, the use of biologics in the pediatric population has not yet been introduced in the literature. Hence, this study reports a unique case involving the use of Dupilumab to treat a pediatric patient with refractory AFRS and bronchial asthma. A 13-year-old girl with a long-standing history of bronchial asthma who was diagnosed with AFRS, started Dupilumab with a loading dose of 600 mg, followed by 300 mg biweekly. The patient showed improvement in her condition after the initiation of Dupilumab, in terms of clinical, endoscopic, and radiological outcomes. Additionally, Dupilumab was shown to be a helpful treatment in controlling the patient's bronchial asthma. In conclusion, Dupilumab appears to be a promising treatment for pediatric patients with refractory AFRS to improve their clinical, endoscopic, and radiological outcomes. However, further studies are needed in the future to validate these findings.