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

doi:10.1016/j.jacig.2024.100314

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

DOI: https://doi.org/10.1016/j.jacig.2024.100314
Journal volume & issue: Vol. 3, no. 4
p. 100314

Abstract

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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.

Published in Journal of Allergy and Clinical Immunology: Global

ISSN: 2772-8293 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://www.sciencedirect.com/journal/journal-of-allergy-and-clinical-immunology-global

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