Effective treatment with omalizumab in patient with severe allergic asthma with persistent mild peripheral blood eosinophilia

A 46-year-old, non-smoking woman, treated for 18 years for allergic asthma associated with chronic sinusitis after bilateral ethmoidectomy in 02.2013, treated for hypertension and after cataract surgery in 2010 permanently treated with glucocorticosteroid treatment, was qualified for omalizumab treatment. She started therapy in March 2014. Despite oral glucocorticosteroids therapy (methylprednisolone 32-4 mg per day), blood eosinophil count remained high. In 16th and 52nd weeks of treatment, the effectiveness of omalizumab was assessed. Symptoms of asthma decreased which were expressed in ACQ and AQLQ along with an improvement in pulmonary function tests, associated with the reduction of daily oral glucocorticosteroids. Regardless of the improvement of asthma symptoms, mild blood eosinophilia was observed. In concomitance of severe asthma. inadequately controlled sinusitis and skin lesion EGPA were taken into account as reasons of all symptoms. EGPA was not confirmed in this patient, and mild eosinophilia was regarded as a phenotypic feature of asthma in this patient. (C) 2016 Published by Elsevier Sp. z o.o. on behalf of Polish Society of Allergology.