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Successful treatment of eosinophilic chronic rhinosinusitis and eosinophilic otitis media using the anti-IL-5 receptor monoclonal antibody benralizumab: A case report.
Respir Med Case Rep. 2020; 30:101135.RM

Abstract

Eosinophilic chronic rhinosinusitis (ECRS) is characterized by the presence of nasal polyps, dominant ethmoid shadows in computed tomography (CT) scans, and elevated levels of eosinophil infiltration into the nasal polyps and peripheral blood. ECRS is often accompanied by severe asthma. The recent development of monoclonal antibody-based biologics, including benralizumab, has offered new therapeutic approaches for the treatment of asthma and allergic diseases. Asthma and ECRS are closely related; hence, benralizumab could provide clinical benefit in ECRS patients with severe asthma. Herein, we report a case of a 47-year-old female patient with severe asthma that presented with nasal obstruction and hearing impairment. Nasal endoscopic and otoscopic examinations indicated the presence of bilateral nasal polyps in the middle nasal meatus, as well as a bilateral effusion in the tympanic cavity. Sinus and temporal CT images showed dominant ethmoid sinus and tympanic cavity shadows. Biopsy of nasal polyps revealed high numbers of eosinophils, which led to the diagnosis of ECRS; eosinophilic otitis media (EOM) with hypereosinophilia was also suspected. Treatment with benralizumab reduced the number of peripheral blood eosinophils and improved asthma symptoms. Prolonged benralizumab administration also resulted in a remarkable size reduction in bilateral middle nasal polyps and aeration of the tympanic cavity. In conclusion, benralizumab treatment improved the symptoms of severe asthma, ECRS, and EOM. Eosinophil depletion could be an important mechanism by which benralizumab improves ECRS and EOM. The use of benralizumab for the treatment of ECRS and EOM patients with severe asthma merits further investigation in large-cohort studies.

Authors+Show Affiliations

Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.Department of Otolaryngology, Tenri Hospital, Nara, Japan.Department of Otolaryngology, Tenri Hospital, Nara, Japan.Department of Otolaryngology, Tenri Hospital, Nara, Japan.Department of Otolaryngology-Head & Neck Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan.Department of Otolaryngology, Tenri Hospital, Nara, Japan.Department of Otolaryngology, Tenri Hospital, Nara, Japan.Department of Otolaryngology, Tenri Hospital, Nara, Japan.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32612919

Citation

Kagoshima, Hiroki, et al. "Successful Treatment of Eosinophilic Chronic Rhinosinusitis and Eosinophilic Otitis Media Using the anti-IL-5 Receptor Monoclonal Antibody Benralizumab: a Case Report." Respiratory Medicine Case Reports, vol. 30, 2020, p. 101135.
Kagoshima H, Hori R, Kojima T, et al. Successful treatment of eosinophilic chronic rhinosinusitis and eosinophilic otitis media using the anti-IL-5 receptor monoclonal antibody benralizumab: A case report. Respir Med Case Rep. 2020;30:101135.
Kagoshima, H., Hori, R., Kojima, T., Okanoue, Y., Taguchi, A., Yamamoto, H., Hasebe, K., & Shoji, K. (2020). Successful treatment of eosinophilic chronic rhinosinusitis and eosinophilic otitis media using the anti-IL-5 receptor monoclonal antibody benralizumab: A case report. Respiratory Medicine Case Reports, 30, 101135. https://doi.org/10.1016/j.rmcr.2020.101135
Kagoshima H, et al. Successful Treatment of Eosinophilic Chronic Rhinosinusitis and Eosinophilic Otitis Media Using the anti-IL-5 Receptor Monoclonal Antibody Benralizumab: a Case Report. Respir Med Case Rep. 2020;30:101135. PubMed PMID: 32612919.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful treatment of eosinophilic chronic rhinosinusitis and eosinophilic otitis media using the anti-IL-5 receptor monoclonal antibody benralizumab: A case report. AU - Kagoshima,Hiroki, AU - Hori,Ryusuke, AU - Kojima,Tsuyoshi, AU - Okanoue,Yusuke, AU - Taguchi,Atsushi, AU - Yamamoto,Hirotaka, AU - Hasebe,Koki, AU - Shoji,Kazuhiko, Y1 - 2020/06/17/ PY - 2020/04/29/received PY - 2020/06/16/revised PY - 2020/06/16/accepted PY - 2020/7/3/entrez PY - 2020/7/3/pubmed PY - 2020/7/3/medline KW - Anti-IL-5 receptor monoclonal antibody KW - Asthma KW - Benralizumab KW - Eosinophilic chronic rhinosinusitis KW - Eosinophilic otitis media SP - 101135 EP - 101135 JF - Respiratory medicine case reports JO - Respir Med Case Rep VL - 30 N2 - Eosinophilic chronic rhinosinusitis (ECRS) is characterized by the presence of nasal polyps, dominant ethmoid shadows in computed tomography (CT) scans, and elevated levels of eosinophil infiltration into the nasal polyps and peripheral blood. ECRS is often accompanied by severe asthma. The recent development of monoclonal antibody-based biologics, including benralizumab, has offered new therapeutic approaches for the treatment of asthma and allergic diseases. Asthma and ECRS are closely related; hence, benralizumab could provide clinical benefit in ECRS patients with severe asthma. Herein, we report a case of a 47-year-old female patient with severe asthma that presented with nasal obstruction and hearing impairment. Nasal endoscopic and otoscopic examinations indicated the presence of bilateral nasal polyps in the middle nasal meatus, as well as a bilateral effusion in the tympanic cavity. Sinus and temporal CT images showed dominant ethmoid sinus and tympanic cavity shadows. Biopsy of nasal polyps revealed high numbers of eosinophils, which led to the diagnosis of ECRS; eosinophilic otitis media (EOM) with hypereosinophilia was also suspected. Treatment with benralizumab reduced the number of peripheral blood eosinophils and improved asthma symptoms. Prolonged benralizumab administration also resulted in a remarkable size reduction in bilateral middle nasal polyps and aeration of the tympanic cavity. In conclusion, benralizumab treatment improved the symptoms of severe asthma, ECRS, and EOM. Eosinophil depletion could be an important mechanism by which benralizumab improves ECRS and EOM. The use of benralizumab for the treatment of ECRS and EOM patients with severe asthma merits further investigation in large-cohort studies. SN - 2213-0071 UR - https://www.unboundmedicine.com/medline/citation/32612919/Successful_treatment_of_eosinophilic_chronic_rhinosinusitis_and_eosinophilic_otitis_media_using_the_anti-IL-5_receptor_monoclonal_antibody_benralizumab:_A_case_report L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-0071(20)30192-1 DB - PRIME DP - Unbound Medicine ER -
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