{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:56:50Z","timestamp":1781672210736,"version":"3.54.5"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis characterized by eosinophilic inflammation and necrotizing vasculitis. Benralizumab, an anti-IL-5R\u03b1 monoclonal antibody that directly targets eosinophils, was approved for EGPA in China in December 2025. We report an early real-world experience of benralizumab combined with corticosteroids in a patient with severe ANCA-negative EGPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 73-year-old male with a history of childhood asthma, chronic rhinosinusitis, CKD stage 4 presented with recurrent pulmonary infiltrates, progressive interstitial lung disease, severe eosinophilia (peak 12.90\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L), diffuse skin lesion and new-onset arrhythmia. After systematic differential diagnosis, EGPA was diagnosed according to the 2022 ACR\/EULAR criteria (score 7). BALF and blood testing detected nucleic acids of\n                      <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                      and CMV. He was treated with methylprednisolone 40 mg\/day and subcutaneous benralizumab 30 mg every 4 weeks. Concurrently, empirical preemptive anti-infective therapy (caspofungin for\n                      <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                      , ganciclovir for CMV) was initiated. At 4-week follow-up, prednisone was tapered to 30 mg\/day; dyspnea and rash markedly improved, eosinophils decreased to 0, IgE fell from 1,860 to 519 IU\/mL, chest CT showed significant resolution of infiltrates, and pulmonary function improved from severe to mild restrictive impairment. At 3 months, prednisone was further tapered to 25 mg\/day in combination with benralizumab, and the patient remained stable without disease relapse or acute infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case represents an early real-world application of benralizumab in a high-risk ANCA-negative EGPA patient following its approval in China. The findings suggest that benralizumab, used as an adjunctive steroid-sparing agent, may facilitate rapid corticosteroid tapering in selected vulnerable patients with infection risk. Long-term follow-up and studies are needed to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1820718","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:45:32Z","timestamp":1781671532000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Benralizumab combined with a steroid-sparing strategy in a case of severe eosinophilic granulomatosis with polyangiitis"],"prefix":"10.3389","volume":"17","author":[{"given":"Nanxi","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxiao","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Dalian Medical University","place":["Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-023-00958-w","article-title":"Evidence-based guideline for the diagnosis and management of eosinophilic granulomatosis with 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