ppharmПедиатрическая фармакологияPediatric pharmacology1727-57762500-3089Издательство «ПедиатрЪ»10.15690/pf.v23i2.3028ppharm-2789Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCASE REPORTОпыт применения генно-инженерного биологического препарата при гиперэозинофильном синдроме у ребенка, перенесшего коронавирусную инфекцию (обзор литературы и описание клинического случая)Experience with a Genetically Engineering Biological Agent in a Child with Hypereosinophilic Syndrome Following Coronavirus Infection: Literature Review and Case Reporthttps://orcid.org/0000-0002-2290-0013БалыковаЛ. А.BalykovaLarisa A.

Балыкова Лариса Александровна, член-корреспондент РАН, доктор медицинских наук, профессор, проректор по инновационной деятельности в сфере биотехнологии и медицины 

430005, г. Саранск, ул. Большевистская, д. 68 

тел.: +7 (927) 276-10-64 

MD, PhD, Professor, Corresponding Member of the RAS 

Saransk 

68, Bolshevistskaya Str., Saransk, 430005 

larisabalykova@yandex.ruКраснопольскаяА. В.KrasnopolskayaAnna V.

Краснопольская Анна Валерьевна, к.м.н.  

Саранск 

MD, PhD 

Saransk 

abalykova@gmail.ruhttps://orcid.org/0000-0003-2927-3224ВерещагинаВ. С.VereshchaginaVeronika S.

Верещагина Вероника Сергеевна, к.м.н., доцент

Саранск  

MD, PhD, Associate Professor 

Saransk 

versver@mail.ruhttps://orcid.org/0000-0002-9049-5662ШирманкинаМ. В.ShirmankinaMarina V.

Ширманкина Марина Васильевна  

Саранск 

MD 

Saransk 

shirmankina99@mail.ruhttps://orcid.org/0009-0009-6581-1211ПигачеваО. Ю.PigachevaOlga Yu.

Пигачева Ольга Юрьевна 

Саранск 

MD 

Saransk 

oyupigacheva@rambler.ruhttps://orcid.org/0009-0004-8555-4578СтрадинаА. А.StradinaAnna A.

Страдина Анна Александровна 

Саранск 

MD 

Saransk 

anna1988strad@icloud.comhttps://orcid.org/0000-0001-5452-0018ЛедяйкинаС. А.LedyaykinaSvetlana A.

Ледяйкина Светлана Александровна 

Саранск 

MD 

Saransk 

thanekrios@inbox.ruНациональный исследовательский Мордовский государственный университет им. Н.П. ОгарёваРоссияN.P. Ogarev National Research Mordovia State UniversityRussian Federation20263105202623262–71Copyright © Балыкова Л.А., Краснопольская А.В., Верещагина В.С., Ширманкина М.В., Пигачева О.Ю., Страдина А.А., Ледяйкина С.А., 20262026Балыкова Л.А., Краснопольская А.В., Верещагина В.С., Ширманкина М.В., Пигачева О.Ю., Страдина А.А., Ледяйкина С.А.Balykova L.A., Krasnopolskaya A.V., Vereshchagina V.S., Shirmankina M.V., Pigacheva O.Y., Stradina A.A., Ledyaykina S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pedpharma.ru/jour/article/view/2789

Обоснование. Гиперэозинофильный синдром (ГЭС) — гетерогенная группа заболеваний, для которой характерны эозинофильная инфильтрация тканей и широкий спектр клинических проявлений. Остается открытым вопрос о патогенетической терапии данного состояния, поскольку часть пациентов рефрактерны к традиционному лечению. Описание клинического случая. В статье рассмотрены основные проблемы дифференциальной диагностики и современные подходы к лечению ГЭС в педиатрической практике, а также представлен редкий клинический случай первичного ГЭС у ребенка 14 лет. После проведения тщательного диагностического поиска и подтверждения диагноза пациентке была назначена терапия системными глюкокортикоидами, давшая временный эффект. Однако в дальнейшем, учитывая развитие тяжелого обострения при попытке отмены гормональной терапии, было инициировано лечение меполизумабом — гуманизированным моноклональным антителом к рецептору интерлейкина 5. Заключение. Ведение пациентов с ГЭС нередко представляет значительные трудности, что связано с полиморфизмом клинических проявлений, необходимостью исключения широкого спектра заболеваний и возможной рефрактерностью к стандартной терапии. Применение генно-инженерного биологического препарата продемонстрировало высокую эффективность, позволив преодолеть зависимость от глюкокортикоидов и предотвратить развитие их побочных эффектов.

Hypereosinophilic syndrome (HES) is a heterogeneous group of disorders characterized by tissue eosinophilic infiltration and a wide spectrum of clinical manifestations. The issue of pathogenetic therapy for this condition remains unresolved, as some patients are refractory to conventional treatment. Case report. This article discusses the main challenges of differential diagnosis and current approaches to the treatment of HES in pediatric practice, and presents a rare clinical case of primary HES in a 14yearold girl. After a thorough diagnostic workup and confirmation of the diagnosis, the patient received systemic glucocorticoid therapy, which produced a temporary effect. However, due to the development of a severe exacerbation upon attempted withdrawal of hormonal therapy, treatment with mepolizumab — a humanized monoclonal antibody against the interleukin5 receptor — was initiated. Conclusion. The management of patients with HES often presents significant difficulties due to the polymorphism of clinical manifestations, the need to rule out a wide range of diseases, and possible refractoriness to standard therapy. The usage of this genetically engineered biological agent demonstrated high efficacy, enabling the patient to overcome glucocorticoid dependence and prevent the development of glucocorticoid-related adverse effects.

гиперэозинофильный синдромгенно-инженерная биологическая терапиямоноклональные антителамеполизумабклинический случайдетиhypereosinophilic syndromegenetically engineered biological therapymonoclonal antibodiesmepolizumabclinical casechildrenОтсутствует.Not specified.ReferencesGotlib I. World Health Organization-defined eosinophilic disorders: 2014 update on diagnosis, risk stratification, and management. Am I Hematol. 2014;89(3):325–337. doi: https://doi.org/10.1002/ajh.23664Gotlib I. World Health Organization-defined eosinophilic disorders: 2014 update on diagnosis, risk stratification, and management. Am I Hematol. 2014;89(3):325–337. doi: https://doi.org/10.1002/ajh.23664Горячкина Л.А., Терехова Е.П. Идиопатический гиперэозинофильный синдром // Эффективная фармакотерапия. — 2012. — № 1. — С. 56–62.Goryachkina LA, Terekhova EP. Idiopaticheskii giperehozinofil’nyi sindrom. Ehffektivnaya farmakoterapiya. 2012;(1):56–62. (In Russ).Wang SA, Orazi A, Gotlib J, et al. 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The authors declare that there are no conflicts of interest present.