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Article Abstract

Eosinophilic granulomatosis with polyangiitis can manifest without eosinophilia and eosinophilic infiltration during benralizumab treatment, emphasizing the need for clinical vigilance beyond eosinophil counts.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396454PMC
http://dx.doi.org/10.1016/j.jacig.2025.100551DOI Listing

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Systematic Literature Review of Real-world Outcomes of Benralizumab in Eosinophilic Granulomatosis with Polyangiitis.

J Allergy Clin Immunol Pract

September 2025

Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, Denver, Colorado, USA. Electronic address:

Background: Several real-world cohorts and numerous case reports investigating benralizumab outcomes in eosinophilic granulomatosis with polyangiitis have been published. These studies complement the limited clinical trial data available by providing early insights on benralizumab use in a broader, real-world population.

Objective: The objective of this systematic literature review (SLR) was to provide an overview of the real-world outcomes of benralizumab in EGPA.

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Hypereosinophilic syndrome (HES) is a hematologic disorder characterized by an increased absolute eosinophil count (AEC) that can lead to tissue infiltration and damage. Idiopathic HES (iHES) comprises a subset of patients with HES, in which a reactive cause such as infections or an inflammatory process cannot be identified, and clonality is not demonstrable. iHES remains a challenge to treat since there is no specific mutation to target.

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Eosinophilic granulomatosis with polyangiitis can manifest without eosinophilia and eosinophilic infiltration during benralizumab treatment, emphasizing the need for clinical vigilance beyond eosinophil counts.

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Eosinophilic granulomatosis with polyangiitis (EGPA, previously known as Churg-Strauss syndrome) is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) often presenting with chronic rhinosinusitis, pulmonary infiltrates, gastrointestinal and cardiac disorders, or renal lesions. Sinonasal and inner ear manifestations are common, but other affections of the head and neck area are rarely reported. Here we report a case of a young woman with a histopathological diagnosis of eosinophil-rich granulomatous inflammation affecting solely the tongue without other local or systemic lesions.

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