Improvement of eosinophilic chronic rhinosinusitis after infection with severe acute respiratory syndrome corona virus 2 during dupilumab therapy: A case report

Frontiers in Allergy

Allergy

Mariko Koike-Ieki¹  Makiko Toma-Hirano¹  Ken Ito¹  Ryoji Kagoya²  Yuko Sasajima³ 

[1] Department of Otolaryngology, Faculty of Medicine, Teikyo University, Tokyo, Japan;Department of Otolaryngology, Faculty of Medicine, Teikyo University, Tokyo, Japan;Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan;

关键词: eosinophilic chronic rhinosinusitis;    dupilumab;    severe acute respiratory syndrome corona virus 2;    cytokine balance;    dysosmia;   

DOI  :  10.3389/falgy.2023.1053777

 received in 2022-09-26, accepted in 2023-01-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

Eosinophilic chronic rhinosinusitis (ECRS) is an intractable type 2 inflammatory disease of the paranasal sinuses that persists even after endoscopic sinus surgery (ESS) and systemic corticosteroid therapy. Dupilumab, a monoclonal antibody against the shared receptor components of interleukin (IL)-4 and IL-13, is a novel and effective treatment option for ECRS. Herein, an atypical case of ECRS that improved after infection with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) during dupilumab therapy is reported. A 40-year-old man with a history of ESS for ECRS visited our hospital with complaints of nasal congestion and dysosmia. Nasal endoscopy revealed bilateral nasal polyps occupying the nasal cavity. Computed tomography (CT) revealed a soft tissue density lesion filling all sinuses on both sides. Based on these findings, ECRS recurrence was confirmed; however, 3 years of subsequent corticosteroid therapy did not improve disease activity. Accordingly, dupilumab therapy was initiated, although 6 months of therapy resulted in only slight improvement in ECRS. Eight months after the initiation of dupilumab therapy, the patient was infected with SARS-CoV-2; thereafter, he noticed an improvement in smell. Nasal endoscopy and sinus CT revealed a marked reduction in nasal polyps and soft tissue density lesions of the sinuses, respectively. With continued dupilumab therapy, no re-exacerbation of ECRS was confirmed at the 6-month follow-up from SARS-CoV-2 infection. Currently, there are no reports describing the impact of SARS-CoV-2 infection on ECRS. As such, careful follow-up and accumulation of cases are necessary.

【 授权许可】

Unknown   
© 2023 Koike-Ieki, Kagoya, Toma-Hirano, Sasajima and Ito.