Eosinophilic Plastic Bronchitis in a Child With Palmoplantar Psoriasis Treated With Ustekinumab

An 8-year-old female developed fever, dyspnea, and cough 1 week after starting ustekinumab for psoriasis. She was noted to have recurrent left lower lobe consolidation and subsequent obstructing eosinophilic casts and was diagnosed with eosinophilic plastic bronchitis. Her respiratory symptoms improved with systemic steroids, mepolizumab for 10 months, and discontinuing ustekinumab. Eosinophilic pneumonia/eosinophilic plastic bronchitis has been rarely reported as an adverse effect of ustekinumab in adults; to our knowledge, it has not previously been reported in children on ustekinumab for a dermatologic indication.