Galcanezumab-associated interstitial pneumonia in a migraine patient: A case report
Abstract
Monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway represent a paradigm shift in migraine prevention, with generally favorable safety profiles. However, CGRP's widespread distribution and immunoregulatory functions raise theoretical concerns about potential off-target effects.
A 41-year-old woman with chronic migraine developed interstitial pneumonia seven weeks after initiating galcanezumab therapy. Extensive diagnostic workup excluded infectious, autoimmune, and implant-related causes. Bronchoalveolar lavage revealed marked lymphocytosis (73%) with inverted CD4/CD8 ratio. Complete radiological resolution occurred three months after drug discontinuation.
To our knowledge this is the first documented case of interstitial lung disease associated with galcanezumab therapy. Despite methodological limitations, the temporal relationship, the distinctive immunological pattern, and resolution after cessation suggest a causal association. This finding emphasizes the need for vigilance regarding rare but potentially serious respiratory adverse events with anti-CGRP therapies.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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