Journal of Allergy and Clinical Immunology: Global (Nov 2024)
Granulomatous hyperinflammatory state induced by dupilumab treatment for eosinophilic esophagitis
- Kanak V. Kennedy, MD,
- Anna Costello, MD,
- Melissa A. Lerman, MD, PhD,
- Jon M. Burnham, MD,
- Aoife Corcoran, MD,
- Joseph Piccione, DO,
- Alexandra Grier, MD, PhD,
- Kathleen Sullivan, MD, PhD,
- Terri Whitehorn-Brown, MD,
- Caitlin J. Alexander, MD,
- Laura S. Finn, MD,
- Benjamin J. Wilkins, MD, PhD,
- Amanda B. Muir, MD
Affiliations
- Kanak V. Kennedy, MD
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Anna Costello, MD
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa; Division of Rheumatology, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Melissa A. Lerman, MD, PhD
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa; Division of Rheumatology, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Jon M. Burnham, MD
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa; Division of Rheumatology, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Aoife Corcoran, MD
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa; Division of Pulmonary and Sleep Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Joseph Piccione, DO
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa; Division of Pulmonary and Sleep Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Alexandra Grier, MD, PhD
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa; Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Kathleen Sullivan, MD, PhD
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa; Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Terri Whitehorn-Brown, MD
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa; Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Caitlin J. Alexander, MD
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Laura S. Finn, MD
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Benjamin J. Wilkins, MD, PhD
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Amanda B. Muir, MD
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pa
- Journal volume & issue
-
Vol. 3,
no. 4
p. 100314
Abstract
We present the first case of a dupilumab-induced hyperinflammatory state in the setting of underlying eosinophilic esophagitis characterized by multisystem granulomatous inflammation. Although clinical trial data and subsequent real-world experience support dupilumab as a highly effective therapy for eosinophilic esophagitis, close monitoring for development of adverse symptoms following initiation remains paramount.
