Development of Eosinophilic Granulomatosis With Polyangiitis Despite Anti–Interleukin‐5 Receptor Therapy: The First Case of Bilateral Central Retinal Artery Occlusion During Benralizumab Treatment

Here, we describe a rare presentation of eosinophilic granulomatosis with polyangiitis (EGPA) under benralizumab therapy manifesting as bilateral central retinal artery occlusion (CRAO). The patient, a 61‐year‐old man with chronic eosinophilic rhinosinusitis and severe asthma, experienced sudden bil...

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Main Authors: Elena Treppo, Lucia Finocchio, Benedetta Fazzi, Maria Pillon, Luca Quartuccio
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:ACR Open Rheumatology
Online Access:https://doi.org/10.1002/acr2.70073
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author Elena Treppo
Lucia Finocchio
Benedetta Fazzi
Maria Pillon
Luca Quartuccio
author_facet Elena Treppo
Lucia Finocchio
Benedetta Fazzi
Maria Pillon
Luca Quartuccio
author_sort Elena Treppo
collection DOAJ
description Here, we describe a rare presentation of eosinophilic granulomatosis with polyangiitis (EGPA) under benralizumab therapy manifesting as bilateral central retinal artery occlusion (CRAO). The patient, a 61‐year‐old man with chronic eosinophilic rhinosinusitis and severe asthma, experienced sudden bilateral visual loss and transient amaurosis. Ophthalmologic evaluations, including a fundus examination and optical coherence tomography, confirmed CRAO, and laboratory test results revealed elevated markers of inflammation and positive antimyeloperoxidase antibodies in the context of normal eosinophil counts. Intensive immunosuppressive therapy led to resolution of systemic inflammation, although significant visual impairment persisted. These findings underscore the potential limitations of anti–interleukin‐5 receptor therapy in preventing vasculitic complications in EGPA.
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spelling doaj-art-459b1dfac8b54bec9e56d0322be4b7172025-08-20T03:35:25ZengWileyACR Open Rheumatology2578-57452025-06-0176n/an/a10.1002/acr2.70073Development of Eosinophilic Granulomatosis With Polyangiitis Despite Anti–Interleukin‐5 Receptor Therapy: The First Case of Bilateral Central Retinal Artery Occlusion During Benralizumab TreatmentElena Treppo0Lucia Finocchio1Benedetta Fazzi2Maria Pillon3Luca Quartuccio4Division of Rheumatology, Department of Medicine University of Udine, Azienda Sanitaria Universitaria del Friuli Centrale Udine ItalyDepartment of Ophthalmology Azienda Sanitaria Universitaria del Friuli Centrale Udine ItalyDivision of Rheumatology, Department of Medicine University of Udine, Azienda Sanitaria Universitaria del Friuli Centrale Udine ItalyDivision of Rheumatology, Department of Medicine University of Udine, Azienda Sanitaria Universitaria del Friuli Centrale Udine ItalyDivision of Rheumatology, Department of Medicine University of Udine, Azienda Sanitaria Universitaria del Friuli Centrale Udine ItalyHere, we describe a rare presentation of eosinophilic granulomatosis with polyangiitis (EGPA) under benralizumab therapy manifesting as bilateral central retinal artery occlusion (CRAO). The patient, a 61‐year‐old man with chronic eosinophilic rhinosinusitis and severe asthma, experienced sudden bilateral visual loss and transient amaurosis. Ophthalmologic evaluations, including a fundus examination and optical coherence tomography, confirmed CRAO, and laboratory test results revealed elevated markers of inflammation and positive antimyeloperoxidase antibodies in the context of normal eosinophil counts. Intensive immunosuppressive therapy led to resolution of systemic inflammation, although significant visual impairment persisted. These findings underscore the potential limitations of anti–interleukin‐5 receptor therapy in preventing vasculitic complications in EGPA.https://doi.org/10.1002/acr2.70073
spellingShingle Elena Treppo
Lucia Finocchio
Benedetta Fazzi
Maria Pillon
Luca Quartuccio
Development of Eosinophilic Granulomatosis With Polyangiitis Despite Anti–Interleukin‐5 Receptor Therapy: The First Case of Bilateral Central Retinal Artery Occlusion During Benralizumab Treatment
ACR Open Rheumatology
title Development of Eosinophilic Granulomatosis With Polyangiitis Despite Anti–Interleukin‐5 Receptor Therapy: The First Case of Bilateral Central Retinal Artery Occlusion During Benralizumab Treatment
title_full Development of Eosinophilic Granulomatosis With Polyangiitis Despite Anti–Interleukin‐5 Receptor Therapy: The First Case of Bilateral Central Retinal Artery Occlusion During Benralizumab Treatment
title_fullStr Development of Eosinophilic Granulomatosis With Polyangiitis Despite Anti–Interleukin‐5 Receptor Therapy: The First Case of Bilateral Central Retinal Artery Occlusion During Benralizumab Treatment
title_full_unstemmed Development of Eosinophilic Granulomatosis With Polyangiitis Despite Anti–Interleukin‐5 Receptor Therapy: The First Case of Bilateral Central Retinal Artery Occlusion During Benralizumab Treatment
title_short Development of Eosinophilic Granulomatosis With Polyangiitis Despite Anti–Interleukin‐5 Receptor Therapy: The First Case of Bilateral Central Retinal Artery Occlusion During Benralizumab Treatment
title_sort development of eosinophilic granulomatosis with polyangiitis despite anti interleukin 5 receptor therapy the first case of bilateral central retinal artery occlusion during benralizumab treatment
url https://doi.org/10.1002/acr2.70073
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