A woman in her 40s with bronchial asthma presented with a 3-week history of limb numbness. Examinations revealed bilateral wheezing and neurological deficits involving both the lower limbs and the right upper limb. Laboratory tests revealed marked eosinophilia (14,300/μL), leading to a diagnosis of eosinophilic granulomatosis with polyangiitis. The initial treatment with prednisolone and intravenous immunoglobulin improved the systemic symptoms; however, peripheral neuropathy persisted. The early initiation of benralizumab therapy resulted in a marked neurological improvement, thus allowing the tapering and discontinuation of prednisolone. At this time, the patient remains relapse-free, suggesting that early benralizumab administration may improve peripheral neuropathy and facilitate corticosteroid withdrawal.
Sakai et al. (Thu,) studied this question.