PMC9791164_01
Progressive worsening of the ICEP (A to D) until introduction of benralizumab and subsequent regression of the radiological signs (e and F).
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The latter showed pulmonary infiltrates and ground glass opacities mainly in the upper lobes (see Fig. 1A). In November 2017, asthma became uncontrolled again: CT-scan was repeated and showed phlogistic confluent parenchymal opacities with air bronchogram, mainly at the apices bilaterally (see Fig. 1B); at the same time, blood samples showed a new increase in eosinophil count (780/microliter/11.5%). Between May 2019 and December 2019 the patient had three more relapses; after being discussed at the multidisciplinary meeting of pulmonary interstitial diseases, the diagnosis of Relapsing Chronic Eosinophilic Pneumonia was confirmed at this point (see Fig. 1C). At the end of May 2020, the patient had a new recurrence with a significant aggravation of asthma (see Fig. 1D) and biologic therapy with benralizumab was consequently started on June 3rd, 2020 (30 mg every 4 weeks for 3 doses and then once every 8 weeks) with prednisone 0.5 mg/kg/die (25 mg). Clinical, functional and radiological stability was maintained after steroid suspension at 6 and 9 months (see Fig. 1F).