array:24 [ "pii" => "S2387020624004121" "issn" => "23870206" "doi" => "10.1016/j.medcle.2024.03.029" "estado" => "S300" "fechaPublicacion" => "2024-10-18" "aid" => "6673" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2024" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2024;163:370-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775324002835" "issn" => "00257753" "doi" => "10.1016/j.medcli.2024.03.023" "estado" => "S300" "fechaPublicacion" => "2024-10-18" "aid" => "6673" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2024;163:370-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Mepolizumab como tratamiento de inducción en la granulomatosis eosinofílica con poliangitis grave" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "370" "paginaFinal" => "371" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Mepolizumab as induction therapy in severe eosinophilic granulomatosis with polyangiitis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 534 "Ancho" => 2050 "Tamanyo" => 190342 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Colonoscopia con patrón de afectación mucosa de origen isquémico secundaria a la vasculitis. Se observa de forma parcheada áreas de mucosa pálida y edematosa alternadas con úlceras de 4-5<span class="elsevierStyleHsp" style=""></span>mm rodeadas de una mucosa violácea (flechas), con pérdida del patrón vascular típico. B) Resonancia magnética nuclear (RM) cardíaca con contraste. Se observa engrosamiento pericárdico (flechas) en presencia de inflamación tisular, e hipocinesia lateral. C) Biopsia cutánea mostrando un patrón de vasculitis leucocitoclástica. Se observan infiltrados inflamatorios superficiales perivasculares constituidos por leucocitos polimorfonucleares con signos de cariorexis, abundantes eosinófilos (flechas) con distribución perivascular e intersticial, focos de necrosis fibrinoide de la pared capilar y extravasación focal de hematíes.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Helena Codes-Méndez, Patricia Moya-Alvarado, Héctor Corominas" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Helena" "apellidos" => "Codes-Méndez" ] 1 => array:2 [ "nombre" => "Patricia" "apellidos" => "Moya-Alvarado" ] 2 => array:2 [ "nombre" => "Héctor" "apellidos" => "Corominas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020624004121" "doi" => "10.1016/j.medcle.2024.03.029" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020624004121?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775324002835?idApp=UINPBA00004N" "url" => "/00257753/0000016300000007/v1_202409300833/S0025775324002835/v1_202409300833/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020624004145" "issn" => "23870206" "doi" => "10.1016/j.medcle.2024.03.030" "estado" => "S300" "fechaPublicacion" => "2024-10-18" "aid" => "6681" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2024;163:371-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Familial aortic aneurysm: A case presentation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "371" "paginaFinal" => "372" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aneurisma de aorta familiar: presentación de un caso" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Martínez-Avial Silva, Pablo Díez-Villanueva, Fernando Alfonso" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María" "apellidos" => "Martínez-Avial Silva" ] 1 => array:2 [ "nombre" => "Pablo" "apellidos" => "Díez-Villanueva" ] 2 => array:2 [ "nombre" => "Fernando" "apellidos" => "Alfonso" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775324003002" "doi" => "10.1016/j.medcli.2024.03.029" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775324003002?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020624004145?idApp=UINPBA00004N" "url" => "/23870206/0000016300000007/v1_202410101439/S2387020624004145/v1_202410101439/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S238702062400411X" "issn" => "23870206" "doi" => "10.1016/j.medcle.2024.03.028" "estado" => "S300" "fechaPublicacion" => "2024-10-18" "aid" => "6672" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2024;163:368-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Membranous nephropathy and Crohn’s disease: Is it a cause and effect or just a coincidence?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "368" "paginaFinal" => "369" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nefropatía membranosa primaria y enfermedad de Crohn: ¿causalidad o coincidencia?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 942 "Ancho" => 1400 "Tamanyo" => 154400 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Colonoscopy with diagnosis of type-A3L2B1 Colonic Crohn's disease, showing friable mucosa with deep, linear punched-out ulcers (arrows).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carolina Fonseca de Jesus Silva, Alberto Martin Arribas, Pilar Fraile Gómez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Carolina" "apellidos" => "Fonseca de Jesus Silva" ] 1 => array:2 [ "nombre" => "Alberto" "apellidos" => "Martin Arribas" ] 2 => array:2 [ "nombre" => "Pilar" "apellidos" => "Fraile Gómez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775324002847" "doi" => "10.1016/j.medcli.2024.03.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775324002847?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S238702062400411X?idApp=UINPBA00004N" "url" => "/23870206/0000016300000007/v1_202410101439/S238702062400411X/v1_202410101439/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Mepolizumab as induction therapy in severe eosinophilic granulomatosis with polyangiitis" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "370" "paginaFinal" => "371" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Helena Codes-Méndez, Patricia Moya-Alvarado, Héctor Corominas" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Helena" "apellidos" => "Codes-Méndez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] 1 => array:4 [ "nombre" => "Patricia" "apellidos" => "Moya-Alvarado" "email" => array:1 [ 0 => "pmoya@santpau.cat" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Héctor" "apellidos" => "Corominas" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Reumatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universitat Autònoma de Barcelona, Bellaterra, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Mepolizumab como tratamiento de inducción en la granulomatosis eosinofílica con poliangitis grave" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 534 "Ancho" => 2050 "Tamanyo" => 190342 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0040" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Colonoscopy with pattern of mucosal involvement of ischaemic origin secondary to vasculitis. Patchy areas of pale, oedematous mucosa alternating with 4-5 mm ulcers surrounded by purplish mucosa (arrows), with loss of the typical vascular pattern. (B) Cardiac magnetic resonance imaging (MRI) with contrast. Pericardial thickening (arrows) in the presence of tissue inflammation, and lateral hypokinesia. (C) Skin biopsy showing a pattern of leukocytoclastic vasculitis. There are superficial perivascular inflammatory infiltrates consisting of polymorphonuclear leukocytes with signs of karyorrhexis, abundant eosinophils (arrows) with perivascular and interstitial distribution, foci of fibrinoid necrosis of the capillary wall and focal red blood cell extravasation.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The latest ACR/EULAR 2021/2022 guidelines<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> have incorporated the recommendation for the use of mepolizumab, an anti-interleukin-5 monoclonal antibody that reduces the total number of eosinophils in the blood, to treat non-severe eosinophilic granulomatosis with polyangiitis (EGPA). The recent inclusion of mepolizumab in the guidelines represents a significant advance in the therapeutic approach to this complex disease. The decision was motivated by the urgent need to address the therapeutic challenges in a disease that carries a considerable risk of morbidity and mortality, especially given the lack of effective and safe treatments for certain patient profiles. The promising results of the MIRRA study,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> the first randomised controlled biologic therapy trial in patients with EGPA, support this recommendation. The study demonstrated the efficacy of mepolizumab by showing a higher remission rate and a lower relapse rate, as well as allowing a more rapid reduction in glucocorticoid use, leading to a significant decrease in the risk of adverse and infectious events. However, current literature on the use of mepolizumab as induction therapy in severe EGPA with organ involvement is limited,<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> highlighting the importance of further research to better understand its role and safety in complex clinical situations.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In this context, we report 2 cases of biopsy-confirmed EGPA, which exhibited severe and atypical manifestations with gastrointestinal and cardiac involvement and were successfully treated with mepolizumab as induction therapy.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The first patient, a 29-year-old male with a history of chronic rhinosinusitis, nasal polyposis and bronchial asthma, presented with constitutional symptoms and gastrointestinal complaints, including abdominal pain, diarrhoeal stools and vomiting with oral intolerance. The second patient, a 64-year-old man with a history of severe allergic rhinitis and persistent asthma, consulted for general malaise and asthenia. Physical examination revealed dull heart tones, left basal pulmonary hypophonesis, and signs of congestion (hepatomegaly, jugular venous distension and hepatojugular reflux).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Both patients had systemic symptoms at baseline, with daily low-grade fever, arthromyalgia and weight loss of more than 5 kg in the previous 2 weeks, as well as skin purpura in the distal area of both legs on examination.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Laboratory studies revealed eosinophilia (5,090 cell/μL-44%, and 6,430 cél/μ L-56%, respectively) and significant acute systemic inflammation (CRP 156 mg/L and 180 mg/L, respectively) in both patients. While the first patient was positive for anti-myeloperoxidase (MPO) antibodies, the second patient was negative for ANCA MPO/PR3 antibodies. In addition, the second patient had dysmorphic microhaematuria in a non-significant range, along with elevations of troponin-I (823 ng/L) and proBNP (5,036 pg/mL) levels.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Colonoscopy performed in the first patient (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) showed a very distinct pattern of inflammatory colitis from the anal margin to a depth of 40 cm, characterised by patchy involvement with areas of pale, oedematous mucosa alternating with 4−5 mm ulcers surrounded by violaceous mucosa and loss of the typical vascular pattern, suggesting an ischaemic pathogenic origin. Intestinal biopsies taken during the procedure showed eosinophilic exocytosis in the glandular epithelium, but did not provide evidence of vasculitis. On the other hand, in the second patient, cardiac MRI (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B) confirmed the presence of acute myopericarditis with slightly decreased LVEF 47%. The diagnosis was confirmed in both cases by skin biopsy, which showed evidence of eosinophilic vasculitis with perivascular inflammation and capillary wall necrosis in the first patient (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C) and a pattern of leukocytoclastic vasculitis in the second.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Despite glucocorticoid pulse therapy (500 mg intravenous ×3) administered to the first patient, an adequate response was not achieved and enteral nutrition had to be resorted to. However, after starting mepolizumab (300 mg subcutaneously, every 4 weeks), he showed significant clinical and laboratory improvement in just 24 h. On the other hand, in the second patient, glucocorticoid pulse therapy and mepolizumab were started as induction therapy, which resulted in a rapid clinical and laboratory improvement.</p><p id="par0040" class="elsevierStylePara elsevierViewall">After 18 months, both patients remain asymptomatic on mepolizumab monotherapy, with no glucocorticoid dependence and no glucocorticoid-related complications.</p><p id="par0045" class="elsevierStylePara elsevierViewall">In conclusion, the experience described in this paper provides evidence for the efficacy of mepolizumab as induction therapy in 2 cases of severe EGPA. Mepolizumab is therefore emerging as a promising therapeutic approach for EGPA, with the potential to treat both mild and severe manifestations of the disease.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0050" class="elsevierStylePara elsevierViewall">The study was approved by the Institutional Ethics Committee of the Hospital de la Santa Creu i Sant Pau and was conducted in accordance with the Declaration of Helsinki.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0055" class="elsevierStylePara elsevierViewall">Not applicable.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interest" ] 3 => array:2 [ "identificador" => "xack780805" "titulo" => "Acknowledgements" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Helena Codes-Méndez and Patricia Moya-Alvarado contributed equally to this work and share co-first authorship.</p>" "identificador" => "fn0005" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 534 "Ancho" => 2050 "Tamanyo" => 190342 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0040" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Colonoscopy with pattern of mucosal involvement of ischaemic origin secondary to vasculitis. Patchy areas of pale, oedematous mucosa alternating with 4-5 mm ulcers surrounded by purplish mucosa (arrows), with loss of the typical vascular pattern. (B) Cardiac magnetic resonance imaging (MRI) with contrast. Pericardial thickening (arrows) in the presence of tissue inflammation, and lateral hypokinesia. (C) Skin biopsy showing a pattern of leukocytoclastic vasculitis. There are superficial perivascular inflammatory infiltrates consisting of polymorphonuclear leukocytes with signs of karyorrhexis, abundant eosinophils (arrows) with perivascular and interstitial distribution, foci of fibrinoid necrosis of the capillary wall and focal red blood cell extravasation.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.A. Chung" 1 => "C.A. Langford" 2 => "M. Maz" 3 => "A. Abril" 4 => "M. Gorelik" 5 => "G. Guyatt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/art.41773" "Revista" => array:7 [ "tituloSerie" => "Arthritis Rheumatol." "fecha" => "2021" "volumen" => "73" "numero" => "8" "paginaInicial" => "1366" "paginaFinal" => "1383" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34235894" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EULAR recommendations for the management of ANCA-associated vasculitis: 2022 update" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Hellmich" 1 => "B. Sanchez-Alamo" 2 => "J.H. Schirmer" 3 => "A. Berti" 4 => "D. Blockmans" 5 => "M.C. Cid" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/ard-2022-223764" "Revista" => array:2 [ "tituloSerie" => "Ann Rheum Dis" "fecha" => "2023" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mepolizumab or placebo for eosinophilic granulomatosis with polyangiitis" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "EGPA Mepolizumab Study Team" "etal" => true "autores" => array:6 [ 0 => "M.E. Wechsler" 1 => "P. Akuthota" 2 => "D. Jayne" 3 => "P. Khoury" 4 => "A. Klion" 5 => "C.A. Langford" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1702079" "Revista" => array:7 [ "tituloSerie" => "N Engl J Med." "fecha" => "2017" "volumen" => "376" "numero" => "20" "paginaInicial" => "1921" "paginaFinal" => "1932" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28514601" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rituximab and mepolizumab combination therapy for glucocorticoid-resistant myocarditis related to eosinophilic granulomatosis with polyangiitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Higashitani" 1 => "R. Yoshimi" 2 => "Y. Sato" 3 => "T. Watanabe" 4 => "A. Ihata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/mrcr/rxab022" "Revista" => array:7 [ "tituloSerie" => "Mod Rheumatol Case Rep." "fecha" => "2022" "volumen" => "6" "numero" => "1" "paginaInicial" => "87" "paginaFinal" => "92" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34473835" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effective treatment with mepolizumab in a patient with severe eosinophilic granulomatosis with polyangiitis complicated with small intestine perforation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Sato" 1 => "M. Yatomi" 2 => "I. Wakamatsu" 3 => "S. Uno" 4 => "C. Hanazato" 5 => "T. Masuda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmcr.2023.101818" "Revista" => array:3 [ "tituloSerie" => "Respir Med Case Rep" "fecha" => "2023" "volumen" => "43" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack780805" "titulo" => "Acknowledgements" "texto" => "<p id="par0065" class="elsevierStylePara elsevierViewall">Not applicable.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016300000007/v1_202410101439/S2387020624004121/v1_202410101439/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016300000007/v1_202410101439/S2387020624004121/v1_202410101439/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020624004121?idApp=UINPBA00004N" ]
Journal Information
Vol. 163. Issue 7.
Pages 370-371 (October 2024)
Share
Download PDF
More article options
Vol. 163. Issue 7.
Pages 370-371 (October 2024)
Letter to the Editor
Mepolizumab as induction therapy in severe eosinophilic granulomatosis with polyangiitis
Mepolizumab como tratamiento de inducción en la granulomatosis eosinofílica con poliangitis grave
Article information
These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscribe
Purchase
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail