{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:09:14Z","timestamp":1789070954264,"version":"build-2803163510"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cardiac involvement, which may remain clinically silent, is a major determinant of prognosis in eosinophilic granulomatosis with polyangiitis, and remission induction generally requires glucocorticoids (GCs) combined with cyclophosphamide or rituximab. In contrast, treatment selection may be challenging in women wishing to preserve fertility because cyclophosphamide carries a risk of gonadal toxicity. We report the case of a 40-year-old woman with a history of asthma, eosinophilic chronic rhinosinusitis, and eosinophilic otitis media who developed postpartum-onset eosinophilic granulomatosis with polyangiitis and presented with neurological and cutaneous manifestations. Elevated cardiac troponin I levels and newly developed electrocardiographic abnormalities suggested subclinical myocardial injury despite the absence of cardiac symptoms. Intravenous methylprednisolone pulse therapy was initiated immediately. Because cardiac troponin I levels showed no early decline after GC initiation, and GC monotherapy was considered potentially insufficient to control eosinophil-mediated myocardial injury, additional eosinophil-targeted therapy was selected after shared decision-making that balanced fertility preservation with the need for prompt disease control. Benralizumab was chosen because of its potent eosinophil-depleting effect. Peripheral eosinophils rapidly decreased to zero, troponin I normalised by Day 26, and GCs were successfully discontinued within 5\u00a0months. To our knowledge, this is the first report of benralizumab used as part of a fertility-preserving remission-induction strategy to avoid cyclophosphamide in a woman with eosinophilic granulomatosis with polyangiitis and cardiac involvement. This approach may represent an individualised therapeutic option for carefully selected patients in whom fertility preservation is an important treatment consideration.<\/jats:p>","DOI":"10.1093\/mrcr\/rxag086","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T19:31:47Z","timestamp":1788204707000},"source":"Crossref","is-referenced-by-count":0,"title":["Benralizumab for eosinophilic granulomatosis with polyangiitis and subclinical cardiac involvement: A fertility-preserving case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5053-5933","authenticated-orcid":false,"given":"Takashi","family":"Yamane","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Kakogawa Central City Hospital , Kakogawa ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Kakogawa Central City Hospital , Kakogawa ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Nishio","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology, Kakogawa Central City Hospital , Kakogawa ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2026091015463633900_ref1","doi-asserted-by":"crossref","first-page":"e005816","DOI":"10.1136\/rmdopen-2025-005816","article-title":"Coronary vasospasms and other cardiac manifestations in eosinophilic granulomatosis with polyangiitis: clinical impact and frequency in a monocentre study of 103 patients","volume":"11","author":"Schramm","year":"2025","journal-title":"RMD Open."},{"key":"2026091015463633900_ref2","doi-asserted-by":"crossref","first-page":"4538","DOI":"10.1093\/rheumatology\/keab027","article-title":"Heart disease in eosinophilic granulomatosis with polyangiitis (EGPA) patients: a screening approach proposal","volume":"60","author":"Garcia-Vives","year":"2021","journal-title":"Rheumatology (Oxford)"},{"key":"2026091015463633900_ref3","doi-asserted-by":"crossref","first-page":"2040622320987051","DOI":"10.1177\/2040622320987051","article-title":"Cardiac manifestations of eosinophilic granulomatosis with polyangiitis from a single-center cohort in China: clinical features and associated factors","volume":"12","author":"Liu","year":"2021","journal-title":"Ther Adv Chronic Dis"},{"key":"2026091015463633900_ref4","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1038\/s41584-023-00958-w","article-title":"Evidence-based guideline for the diagnosis and management of eosinophilic granulomatosis with polyangiitis","volume":"19","author":"Emmi","year":"2023","journal-title":"Nat Rev Rheumatol"},{"key":"2026091015463633900_ref5","doi-asserted-by":"crossref","first-page":"e003083","DOI":"10.1136\/rmdopen-2023-003083","article-title":"Systematic literature review informing the 2022 update of the EULAR recommendations for the management of ANCA-associated vasculitis (AAV): part 2 - treatment of eosinophilic granulomatosis with polyangiitis and diagnosis and general management of AAV","volume":"9","author":"Sanchez-Alamo","year":"2023","journal-title":"RMD Open"},{"key":"2026091015463633900_ref6","first-page":"2571","article-title":"Risk of ovarian failure and fertility after intravenous cyclophosphamide. 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