Tacrolimus successfully used to control refractory eosinophilic granulomatosis with polyangiitis complicated by invasive aspergillosis and chronic hepatitis B.

Abstract

While several alternatives to cyclophosphamide have been proposed for refractory eosinophilic granulomatosis with polyangiitis (EGPA), therapeutic options are limited in patients with chronic infections. We report a case of refractory EGPA complicated by invasive aspergillosis and chronic hepatitis B. Although multiple immunosuppressants, including cyclophosphamide, were not effective, tacrolimus was used successfully to control disease without exacerbating concomitant infections in the long term. Tacrolimus could be an alternative choice in the treatment of EGPA, especially when aggressive immunosuppression is unfeasible.

• Authors: Fumio Hirano, Fumitaka Mizoguchi, Masayoshi Harigai, Nobuyuki Miyasaka, Hitoshi Kohsaka
• Journal: International journal of rheumatic diseases (Int J Rheum Dis) Vol. 22 Issue 4 Pg. 746-749 (Apr 2019) ISSN: 1756-185X [Electronic] England
• PMID: 27125472 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Chemical References

• Antifungal Agents
• Antiviral Agents
• Immunosuppressive Agents
• Tacrolimus

Topics

• Antifungal Agents (therapeutic use)
• Antiviral Agents (therapeutic use)
• Churg-Strauss Syndrome (drug therapy, immunology)
• Drug Substitution
• Hepatitis B, Chronic (drug therapy, immunology, virology)
• Humans
• Immunocompromised Host
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Invasive Pulmonary Aspergillosis (drug therapy, immunology, microbiology)
• Male
• Middle Aged
• Opportunistic Infections (drug therapy, immunology, microbiology, virology)
• Tacrolimus (therapeutic use)
• Treatment Outcome