Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis associated with chronic rhinosinusitis (CRS) and bronchial asthma. Mepolizumab, an anti-IL-5 monoclonal antibody, has been used in the treatment of EGPA. We report two cases of MPO-ANCA-positive EGPA with CRS that exhibited differing responses to mepolizumab. In Case 1, nasal symptoms persisted despite mepolizumab treatment, and CRS recurred early after endoscopic sinus surgery (ESS). In contrast, Case 2 developed EGPA following dupilumab administration, but nasal symptoms improved with mepolizumab and remained well controlled. These cases suggest that the efficacy of mepolizumab for CRS in ANCA-positive EGPA varies among patients. Even in cases that respond well to treatment, recurrence may still occur, underscoring the importance of continuous follow-up in close collaboration with internal medicine specialists.
"},{"@language":"ja","@value":"好酸球性多発血管炎性肉芽腫症（EGPA）は，鼻副鼻腔炎や気管支喘息を伴う全身性血管炎であり，抗IL-5抗体であるメポリズマブが治療に用いられる．本研究では，MPO-ANCA陽性EGPAに合併した慢性鼻副鼻腔炎（CRS）に対し，メポリズマブの効果が異なった2例を報告する．症例1はメポリズマブ投与中も鼻症状が持続し，ESSを行ったが早期に再発した．症例2はデュピルマブ投与を契機にEGPAを発症し，メポリズマブ導入後に鼻症状が軽快し，長期にわたり再発を認めなかった．ANCA陽性のEGPAに伴うCRSに対するメポリズマブの効果は症例により異なることが明らかとなった．効果を示した症例も再燃の可能性があり，内科と連携しながら経過を観察することが重要である．
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410587295719454211","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"神村 盛一郎"},{"@language":"en","@value":"Kamimura Seiichiro"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School"},{"@language":"ja","@value":"徳島大学医学部耳鼻咽喉科・頭頸部外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410587295719454209","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"両角 遼太"},{"@language":"en","@value":"Morozumi Ryota"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School"},{"@language":"ja","@value":"徳島大学医学部耳鼻咽喉科・頭頸部外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410587295719454208","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"石谷 圭佑"},{"@language":"en","@value":"Ishitani Keisuke"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School"},{"@language":"ja","@value":"徳島大学医学部耳鼻咽喉科・頭頸部外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410587295719454210","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"北村 嘉章"},{"@language":"en","@value":"Kitamura Yoshiaki"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School"},{"@language":"ja","@value":"徳島大学医学部耳鼻咽喉科・頭頸部外科"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"00214884"},{"@type":"LISSN","@value":"00214884"},{"@type":"EISSN","@value":"13477935"}],"prism:publicationName":[{"@language":"ja","@value":"アレルギー"},{"@language":"en","@value":"Japanese Journal of Allergology"},{"@language":"ja","@value":"アレルギー"},{"@language":"en","@value":"Japanese Journal of Allergology"}],"dc:publisher":[{"@language":"en","@value":"Japanese Society of Allergology"},{"@language":"ja","@value":"一般社団法人 日本アレルギー学会"}],"prism:publicationDate":"2025-10-10","prism:volume":"74","prism:number":"5","prism:startingPage":"277","prism:endingPage":"284"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2026063178"}],"availableAt":"2025-10-10","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=anti-neutrophil%20cytoplasmic%20antibody","dc:title":"anti-neutrophil cytoplasmic antibody"},{"@id":"https://cir.nii.ac.jp/all?q=endoscopic%20sinus%20surgery","dc:title":"endoscopic sinus surgery"},{"@id":"https://cir.nii.ac.jp/all?q=eosinophilic%20chronic%20rhinosinusitis","dc:title":"eosinophilic chronic rhinosinusitis"},{"@id":"https://cir.nii.ac.jp/all?q=eosinophilic%20granulomatosis%20with%20polyangiitis","dc:title":"eosinophilic granulomatosis with polyangiitis"},{"@id":"https://cir.nii.ac.jp/all?q=mepolizumab","dc:title":"mepolizumab"},{"@id":"https://cir.nii.ac.jp/all?q=anti-neutrophil%20cytoplasmic%20antibody","dc:title":"anti-neutrophil cytoplasmic antibody"},{"@id":"https://cir.nii.ac.jp/all?q=endoscopic%20sinus%20surgery","dc:title":"endoscopic sinus surgery"},{"@id":"https://cir.nii.ac.jp/all?q=eosinophilic%20chronic%20rhinosinusitis","dc:title":"eosinophilic chronic rhinosinusitis"},{"@id":"https://cir.nii.ac.jp/all?q=eosinophilic%20granulomatosis%20with%20polyangiitis","dc:title":"eosinophilic granulomatosis with polyangiitis"},{"@id":"https://cir.nii.ac.jp/all?q=mepolizumab","dc:title":"mepolizumab"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2014611706"},{"@type":"PUBMED","@value":"41083348"}]}