• Internal medicine · Jun 2024

    A Case in which Eosinophilic Meningoencephalitis Occurred during Oral Corticosteroid Tapering and after Switching from Anti-IL-5 to Anti-IgE Treatment.

    • Yuuya Nishii, Takashi Kinoshita, Jun Sasaki, Tsuneyoshi Shingo, Irie Kenichi, Takahisa Tateishi, Masaki Tominaga, Takayuki Taniwaki, Tomoaki Hoshino, and Tomotaka Kawayama.
    • Division of Respirology, Neurology, and Rheumatology Department of Internal Medicine, Kurume University School of Medicine, Japan.
    • Intern. Med. 2024 Jun 6.

    AbstractA 49-year-old man with severe eosinophilic asthma, sinusitis, and esophagitis was admitted with a sudden severe headache. The patient was diagnosed with eosinophilic meningoencephalitis based on frontotemporal abnormalities on brain magnetic resonance imaging and high eosinophil counts in the cerebrospinal fluid. His allergic-disease control levels were poor, requiring regular oral corticosteroid (OCS) use. He was switched from anti-interleukin (IL)-5 to anti-IgE therapy because of worsening urticaria and asthma symptoms during OCS tapering. We suspect this was a case of complex eosinophilic meningoencephalitis caused by the combination of OCS tapering and anti-IL-5 therapy cessation that acquired anti-IgE antibody sensitization based on positive drug-induced lymphocyte stimulation test results.

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