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Drug‐induced granulomatosis: is dupilumab the new kid on the block?

N Belhomme

Corresponding Author

E-mail address: nicolas.belhomme@chu-rennes.fr

Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France

Corresponding author: Nicolas Belhomme, MD

Department of Internal Medicine, Pontchaillou‐Rennes University Hospital, 35000 Rennes, France CHU Pontchaillou, 2 rue Henri Le Guilloux, 35 000 Rennes, France

E‐mail: nicolas.belhomme@chu-rennes.fr

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T Gaignon

Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France

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S Jouneau

Department of Respiratory Medicine, Rennes University Hospital, University of Rennes 1, Rennes, France

INSERM‐IRSET UMR1085, University of Rennes 1, Rennes, France

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L Misery

Department of Dermatology, Brest University Hospital and Brest University, Brest, France

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C Abasq‐Thomas

Department of Dermatology, Brest University Hospital and Brest University, Brest, France

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B Cador

Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France

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V Lecureur

Rennes University Hospital, University of Rennes 1, Inserm, EHESP, IRSET UMR1085, Rennes, France

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S Cadiou

Department of Rheumatology, Rennes University Hospital, University of Rennes 1, Rennes, France

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A Ballerie

Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France

INSERM‐IRSET UMR1085, University of Rennes 1, Rennes, France

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E Polard

Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, Rennes University Hospital, Rennes, France

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S Mensi

Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France

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P Jego

Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France

INSERM‐IRSET UMR1085, University of Rennes 1, Rennes, France

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A Lescoat

Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France

INSERM‐IRSET UMR1085, University of Rennes 1, Rennes, France

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First published: 20 January 2020

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/jdv.16218

Abstract

Dupilumab is an IgG4 antibody directed toward IL‐4 and IL‐13, two major effectors of the Th2 immunity response. It was originally developed for severe and/or refractory atopic dermatitis, nevertheless its use has secondarily been broadened to severe asthma 1.

We report herein the case a 28‐year‐old, non‐smoker male who presented to the emergency department with confusion, headaches, emesis and photophobia. His medical history included only a severe atopic dermatitis leading to dupilumab initation 4 months earlier. Physical examination revealed a meningoencephalitis syndrome, and a bilateral parotidomegaly.

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