{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:20:03Z","timestamp":1787980803098,"version":"build-2784847793"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:00:00Z","timestamp":1686182400000},"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. Pharmacol."],"abstract":"<jats:p>Idiopathic hypereosinophilic syndrome (IHES) is a rare disease characterized by causeless persistent hypereosinophilia and eosinophilia-associated end-organ damage. Current treatment modalities don\u2019t meet the needs due to adverse events of steroids as first-line therapy and the limited efficacy of second-line treatments, underscoring the need for new therapeutic strategies. Here we presented two cases of IHES with different clinical manifestations that were both refractory to corticosteroids. Patient #1 experienced rashes, cough, pneumonia, and steroid-induced side effects. Patient #2 had severe gastrointestinal symptoms attributed to hypereosinophilia. They both had high levels of serum IgE, didn\u2019t respond well to second-line treatments of interferon-\u03b1 (IFN-\u03b1) and imatinib, and Mepolizumab was not accessible. We then innovatively switched to Omalizumab, an anti-IgE monoclonal antibody approved for allergic asthma and chronic idiopathic urticaria. Patient #1 was treated with Omalizumab 600\u00a0mg per month for 20\u00a0months; his absolute eosinophil count (AEC) decreased significantly and has stabilized at around 1.0\u00d710<jats:sup>9<\/jats:sup>\/L for 17\u00a0months, with complete relief from erythra and cough. Patient #2 recovered promptly from severe diarrhea with a sharp drop in AEC after 3\u00a0months of treatment with omalizumab at 600\u00a0mg per month. Therefore, we concluded that Omalizumab may be a seminal therapeutic strategy for IHES patients who are refractory to corticosteroids, whether as long-term management of AEC or as an urgent intervention to address severe symptoms caused by eosinophilia.<\/jats:p>","DOI":"10.3389\/fphar.2023.1095737","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T04:37:35Z","timestamp":1686199055000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Case Report: Off-label treatment of idiopathic hypereosinophilic syndrome with Omalizumab"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhiyu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingxin","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Ning","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,8]]},"reference":[{"key":"B1","volume-title":"NCCN guidelines version 4.2021 myeloid\/lymphoid neoplasms with eosinophilia and tyrosine kinase fusion genes NCCN evidence blocks TM continue NCCN guidelines panel disclosures","author":"Ali","year":"2021"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e3271","DOI":"10.6061\/clinics\/2021\/e3271","article-title":"Mepolizumab in hypereosinophilic syndrome: A systematic review and meta-analysis","volume":"76","author":"Alves J\u00fanior","year":"2021","journal-title":"Clin. 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