Early benralizumab for eosinophilic myocarditis in eosinophilic granulomatosis with polyangiitis

Eosinophilic myocarditis is a life-threatening complication of eosinophilic syndromes including eosinophilic granulomatosis with polyangiitis (EGPA), undefined complex hypereosinophilic syndrome (HES), and drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. The in-hospital death rate for eosinophilic myocarditis due to any cause is about 20%,1 and is as high as 50% in its acute necrotizing form associated with DRESS.2 Conventional therapies including high-dose glucocorticoids and other immunosuppressants have variable efficacy and substantial toxic effects.1 Dilated cardiomyopathy is a frightening sequela but its incidence is unknown.