Novel treatment of eosinophilic bronchitis with allergic fungal sinusitis using mepolizumab- One year follow-up.

We presented a rare case report at the 2017 ERS on a patient with eosinophilic bronchitis with allergic fungal sinusitis treated with mepolizumab. The patient was administered a combination of steroid and mepolizumab (100mg/month). Tapering of steroid was completed after 2 months of treatment, and the patient continued treatment of mepolizumab. He has remained symptom free. After 1 year we chose to re-examination the patient, which included bronchoscopy and a multi-disciplinary treatment for severe asthma. The results of lung function test were VC, 5.06 L (115.2%); FEV1, 2.84 L (67.0%); and FEV1% (G), 60.84%. The Fractional nitric oxide concentration in exhaled breath (FeNO) was 38 ppb. Bronchoscopy revealed a remarkable improvement for the airway surface with rubefaction. Eosinophil levels were low for bronchoalveolar lavage (BAL) and goblet cells were partially observed in the bronchial mucosal membrane region. Inflammatory cell infiltration, mainly lymphocytes were observed in the interstitial region. Low levels of eosinophil was observed in the interstitial region, and in the blood capillaries. This histological report describes broncoscopy and physical findings after one year of continued mepolizumab administration.