Refractory flare-up of severe bronchial asthma controlled with mepolizumab due to Pneumocystis pneumonia: a case report

Abstract Background Biologics dramatically improve symptoms of severe asthma; however, various exacerbating factors may induce flare-up. Pneumocystis spp. have not been reported as a cause of asthma exacerbation during biologic use, although patients with severe asthma have high levels of antibodies...

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Bibliographic Details
Main Authors: Kazuya Takeda, Toshiyuki Sumi, Yuta Nagahisa, Keigo Matsuura, Motoki Sekikawa, Hiroki Watanabe, Yuichi Yamada, Hirofumi Chiba
Format: Article
Language:English
Published: BMC 2022-04-01
Series:Allergy, Asthma & Clinical Immunology
Subjects:
Online Access:https://doi.org/10.1186/s13223-022-00678-y
Description
Summary:Abstract Background Biologics dramatically improve symptoms of severe asthma; however, various exacerbating factors may induce flare-up. Pneumocystis spp. have not been reported as a cause of asthma exacerbation during biologic use, although patients with severe asthma have high levels of antibodies against Pneumocystis spp. Case presentation An 87-year-old female with severe asthma that was well-controlled with mepolizumab, who developed a steroid-resistant refractory flare-up. Chest computed tomography showed bilateral ground glass opacities, and results of polymerase chain reaction tests on induced sputum were positive for Pneumocystis DNA. Therefore, a diagnosis of Pneumocystis pneumonia was made. The clinical symptoms improved after treatment with sulfamethoxazole–trimethoprim. Conclusion Clinicians should be aware of Pneumocystis pneumonia as a cause of refractory exacerbation of bronchial asthma during use of interleukin-5 inhibitors.
ISSN:1710-1492