ArticleJPGN reports2026
Benralizumab for anti-tumor necrosis factor-associated eosinophilic gastrointestinal disease in a child with ileal Crohn's: A case report.
Article in JPGN reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Crohn's disease (CD) and eosinophilic gastrointestinal diseases (EGIDs) are distinct inflammatory entities, but eosinophilic disease may emerge as a paradoxical immune complication of anti-tumor necrosis factor therapy. We report a 12-year-old boy with terminal ileal CD who developed severe eosinophilic gastritis and ileitis, peripheral eosinophilia, and psoriasiform dermatitis during prolonged anti-TNF treatment, despite CD remission. Corticosteroids, dietary modification, and sequential biologic therapy resulted in incomplete or transient responses. Following anti-TNF withdrawal, eosinophilic disease persisted, prompting compassionate off-label treatment with benralizumab, an interleukin-5 (IL-5) receptor α-antagonist, alongside vedolizumab for CD maintenance. Benralizumab led to rapid normalization of peripheral eosinophil counts, resolution of gastrointestinal symptoms, improved food tolerance, and histologic remission at 6 months. This case illustrates persistent anti-TNF-associated immune deviation and supports targeted IL-5 receptor blockade as an effective strategy for refractory eosinophilic gastrointestinal disease while maintaining CD remission.
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