Eosinophilic Bronchiolitis Diagnosed by a Transbronchial Lung Cryobiopsy and Successfully Treated with Biologic Agents: A Report of Two Cases and Literature Review.
Katsuhiro Itogawa, Masako Amano, Daisuke Nakatani et al.
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Case in brief
Two patients with refractory asthma were diagnosed with eosinophilic bronchiolitis, an airway disease marked by eosinophilic inflammation of the bronchioles. Diagnosis was established using transbronchial lung cryobiopsy, a less invasive procedure than surgical biopsy. Both patients responded to oral corticosteroids and biologic therapy; the biologic agents used were dupilumab and benralizumab.
What made this case unusual
The cases describe successful management of eosinophilic bronchiolitis with dupilumab and benralizumab, alongside diagnosis using transbronchial lung cryobiopsy.
Diagnostic / clinical pearl
In patients with refractory asthma and suspected eosinophilic bronchiolitis, transbronchial lung cryobiopsy may provide diagnostic tissue without surgical biopsy.
Why it matters
The reported responses suggest biologic agents may have a corticosteroid-sparing role in eosinophilic bronchiolitis, although these two cases do not establish efficacy.