• Internal medicine · Jan 2023

    Case Reports

    Successful Treatment with Mepolizumab for Coronary Spastic Angina Associated with Eosinophilic Granulomatosis with Polyangiitis.

    • Yuki Takigawa, Keiichi Fujiwara, Isao Tabuchi, Kenichiro Kudo, Kazuna Hayashi, Shoichiro Matsumoto, Hiroki Omori, Suzuka Matsuoka, Sho Mitsumune, Hiromi Watanabe, Akiko Sato, Ken Sato, and Takuo Shibayama.
    • Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan.
    • Intern. Med. 2023 Jan 1; 62 (16): 238923932389-2393.

    AbstractA 46-year-old man with a history of bronchial asthma and chronic sinusitis presented to our hospital with chest pain. We suspected angina evoked by epicardial coronary spasm and performed an ergonovine provocation test to diagnose coronary spastic angina (CSA). The patient also met the diagnostic criteria for eosinophilic granulomatosis with polyangiitis (EGPA) and was treated with 60 mg prednisolone (PSL) for EGPA-associated CSA. After PSL administration, eosinophils decreased, and angina attacks disappeared. However, when PSL was tapered to 12.5 mg, chest pain recurred. We administered mepolizumab subcutaneously and chest pain disappeared. Additional mepolizumab may be effective for EGPA with CSA.

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