Mepolizumab rescue therapy for acute pneumonitis secondary to DRESS

Onn Shaun Thein, Benjamin Sutton, David R Thickett, Dhruv Parekh

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome represents a severe adverse drug reaction driven by eosinophilia. Treatment is focused on withdrawal of medication, supportive care and immunosuppression such as high-dose corticosteroid therapy. Here we report a 56-year-old male patient who initially presented with breathlessness and eosinophilia, subsequent development of respiratory failure and admission to ITU for non-invasive ventilation. The patient continued to deteriorate despite high-dose prednisolone and methylprednisolone. Other causes of hypereosinophilia were normal. He was diagnosed with DRESS syndrome secondary to pregabalin and was treated with subcutaneous mepolizumab. We observed the rapid resolution of eosinophilia and clinical improvement; the patient was discharged home within a month of administration. This represents the successful use of mepolizumab in the acute setting of pulmonary failure secondary to DRESS. A similar approach could be adopted in other acute conditions with refractory eosinophilic inflammation where standard steroid therapy has failed.

Original languageEnglish
JournalBMJ case reports
Issue number10
Publication statusPublished - 10 Oct 2019

Bibliographical note

© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.


  • Antibodies, Monoclonal, Humanized/therapeutic use
  • Diagnosis, Differential
  • Drug Hypersensitivity Syndrome/complications
  • Eosinophilia/complications
  • Humans
  • Male
  • Middle Aged
  • Pneumonia/drug therapy
  • Pregabalin/adverse effects


Dive into the research topics of 'Mepolizumab rescue therapy for acute pneumonitis secondary to DRESS'. Together they form a unique fingerprint.

Cite this