Abstract
Omalizumab is an anti-immunoglobulin E (IgE) monoclonal antibody used to treat severe allergic asthma. Although most of the reported cases of omalizumab-associated eosinophilic granulomatous polyangiitis (EGPA) are attributed to the accompanying glucocorticoid reduction, a patient who met the 2022 American College of Rheumatology diagnostic criteria for EGPA yet had no history of systemic glucocorticoid treatment is described. This individual developed limb numbness accompanied by eosinophilia (14.24 × 109/L) within 22 days after initiating omalizumab therapy. Critical warning: In asthmatic patients treated with omalizumab, if persistent eosinophilia or new neurological symptoms occur, the possibility of EGPA should be highly vigilant and evaluated. Cite this article as: Wang Z, Lin S, Yang J, Cheng M, Cai M. Eosinophilic granulomatous polyangiitis emerging after omalizumab administration: an asthma patient without systemic corticosteroids develops mononeuritis multiplex after 22 days. Eur J Rheumatol. 2026, 13(1), 0048, doi: 10.5152/eurjrheum.2026.25048.