A 57-year-old woman with poorly controlled diabetes was admitted to our hospital for additional treatment of severe
asthma. Although
bronchial thermoplasty was performed in the both upper lobes,
cough and dyspnoea gradually appeared 2 weeks later. High-resolution computed tomography revealed thickness of intralobular septa and a diffuse ground-glass attenuation in the lung fields. Laboratory examination revealed elevated levels of serum eosinophils and total
immunoglobulin E. Bronchoalveolar lavage fluid showed a remarkable increase of eosinophils as high as 48.5%, then
eosinophilic pneumonia was diagnosed. Although treatment with
steroids resulted in an improvement of
eosinophilic pneumonia, the treatment was discontinued after 4 days because it worsened her diabetic condition. Since
eosinophilic pneumonia recurred after discontinuing
steroid,
mepolizumab was administered, which subsequently improved
her disease condition. Clinicians should be aware that
bronchial thermoplasty can lead to
eosinophilic pneumonia and
mepolizumab might be an effective treatment in this setting.