Marked response to dupilumab in a patient with multiple type 2 inflammatory disorders
Pages 186 to 188
Cite this article
- MATSUO, Maho,
- ITO, Yuki,
- SHIRATO, Hiromichi,
- TAKAGI, Hajime
- and IWATA, Iroaki,
- Matsuo, Maho.,
- et al.
- Matsuo, M.,
- Ito, Y.,
- Shirato, H.,
- Takagi, H.
- and Iwata, I.
https://doi.org/10.1684/ejd.2026.5053
Cite this article
- Matsuo, M.,
- Ito, Y.,
- Shirato, H.,
- Takagi, H.
- and Iwata, I.
- Matsuo, Maho.,
- et al.
- MATSUO, Maho,
- ITO, Yuki,
- SHIRATO, Hiromichi,
- TAKAGI, Hajime
- and IWATA, Iroaki,
https://doi.org/10.1684/ejd.2026.5053
Dupilumab is available for the treatment of Th2-dominant inflammatory disorders, such as atopic dermatitis (AD). We report a patient affected by multiple type 2 inflammatory diseases, including chronic spontaneous urticaria (CSU), eosinophilic esophagitis (EoE), bronchial asthma, and chronic rhinosinusitis, in whom clinical remission was achieved with dupilumab.
A 62-year-old Japanese woman with a history of AD in childhood, currently untreated and receiving fexofenadine hydrochloride and bilastine for allergic rhinitis, presented with urticaria on her extremities without identifiable triggers, leading to a diagnosis of CSU (figure 1A). There was no known family history of AD. Blood tests demonstrated an eosinophil count of 171/μL, serum IgE of 182 IU/mL, and thymus and activation-regulated chemokine (TARC) of 330 pg/mL. Pollen-specific IgE were elevated for cedar, cypress, and alder. An additional treatment with olopatadine hydrochloride was administered, resulting in temporary improvement of urticaria. One month after the onset of urticaria, she felt heartburn before and after meals. Upper endoscopy revealed longitudinal furrows, annular rings, and white exudates in the oesophagus (figure 1B). Histopathological examination demonstrated epithelial thickening with eosinophilic infiltration, averaging 29 eosinophils per high-power field (HPF), confirming the diagnosis of EoE. Vonoprazan fumarate was initiated but failed to improve symptoms, prompting initiation of prednisolone (PSL) 10 mg/d…
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