A case of episodic angioedema with eosinophilia controlled by anti-IL5receptor antibody treatment
10.4168/aard.2026.14.2.93
- Author:
Hyo-In RHYOU
1
;
Young-Hee NAM
;
Hae-Sim PARK
Author Information
1. Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea
- Publication Type:CASE REPORT
- From:Allergy, Asthma & Respiratory Disease
2026;14(2):93-96
- CountryRepublic of Korea
- Language:English
-
Abstract:
Episodic angioedema with eosinophilia (EAE) is a rare disorder characterized by recurrent episodes of angioedema accompanying peripheral blood eosinophilia. Oral corticosteroids (OCS) are the primary treatment; however, concerns remain regarding potential adverse effects associated with frequent or long-term use of OCS. Although the pathophysiological mechanisms underlying EAE remain unclear, studies have reported an association between T-cell clonality and subsequent elevation of interleukin (IL)-5 levels. A 43-year-old male had experienced facial and hand edema accompanied by eosinophilia since 2020. During episodes of angioedema, he exhibited febrile sensation and rapid weight gain within a few hours, along with dyspnea and severe pruritus. To control symptoms, continuous OCS therapy was required. In 2021, he was treated with anti-IL 5 antibody (reslizumab 200 mg) for 3 months, which was ineffective. Subsequently, he visited Ajou University Hospital in November 2022 for additional disease management. He had been taking deflazacort (8–32 mg/day) and cyclosporine (75–200 mg/day); however, his EAE was not controlled during which higher doses of OCS had been used. Laboratory findings revealed variations in blood eosinophils according to the symptom status and OCS dose, and general reductions in immunoglobulin G2 (IgG2), IgG3, and IgG levels due to long-term use of OCS. Since anti-interleukin (IL)-5 receptor antibody (benralizumab, 30 mg) and intravenous immunoglobulin were regularly administered at 4-week intervals, no further attacks of EAE have been observed with stopping OCS treatment. Severe EAE refractory to anti-IL-5 antibody as well as OCS therapy could be controlled by anti-IL-5 receptor antibody as an effective steroid-sparing agent.
