Long-term efficacy of anti-IL-4 receptor antibody in a patient with aspirin-exacerbated respiratory disease and IgG4-related disease

Allergy, Asthma & Clinical Immunology

Case Report

Hyun-Seob Jeon¹  Jae-Hyuk Jang¹  Hae-Sim Park¹  Youngsoo Lee¹ 

[1] Department of Allergy and Clinical Immunology, Ajou University School of Medicine, 16499, Suwon, Gyeonggi-do, South Korea;

关键词: Dupilumab;    AERD;    Severe asthma;    Chronic rhinosinusitis, nasal polyps;    IgG4;    IL-4 receptor;    Type 2 airway inflammation;   

DOI  :  10.1186/s13223-023-00825-z

 received in 2023-05-08, accepted in 2023-07-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAspirin-exacerbated respiratory disease (AERD) and IgG4-related disease (IgG4RD) share a common pathway of Th2-mediated immune mechanism; there have been several cases of IgG4RD developed in patients with asthma, especially in those comorbid with chronic rhinosinusitis (CRS). IgG4RD has often been treated with systemic corticosteroids, rituximab, or immune-suppressive agents, but frequently failed with relapse.Case presentationHere, we present a case of a 64-year-old male patient with severe AERD with CRS complicated with IgG4RD, who has been successfully treated and maintained with anti-IL-4 receptor antibody, dupilumab after achieving unsatisfactory responses with previous treatments including steroids, rituximab, omalizumab, and reslizumab. The patient’s symptoms (periorbital swelling and asthmatic/nasal symptoms) were remarkably improved; serum levels of IgG4/IgE as well as plasmablast/eosinophil counts progressively decreased without any recurrence sign for over 2 years of dupilumab treatment.ConclusionThese findings demonstrate that blocking the IL-4/IL-13 pathway with dupilumab can be an effective treatment with long-term safety in patients with severe AERD with CRS complicated by IgG4RD.

【 授权许可】

CC BY   
© Canadian Society of Allergy & Clinical Immunology 2023

【 图 表 】

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