Dupilumab as maintenance therapy in steroid-dependent eosinophilic enteritis: a multidisciplinary approach

Eosinophilic enteritis is a rare immune-mediated disorder for which systemic corticosteroids remain the mainstay of treatment during acute flares, although no standardized maintenance therapy exists and some patients develop recurrent disease requiring repeated steroid courses. We report the case of a 27-year-old man with steroid-dependent eosinophilic enteritis characterized by recurrent flares with abdominal pain, diarrhea, ascites, and peripheral eosinophilia. After exclusion of alternative causes of eosinophilia through a multidisciplinary evaluation, off-label dupilumab was initiated, allowing complete corticosteroid withdrawal, with good tolerability. After one year of follow-up, he maintained remission and was able to reintroduce previously restricted foods, supporting its potential role as a steroid-sparing maintenance therapy in selected patients with eosinophilic enteritis.