IGHE and eosinophilic granulomatosis with polyangiitis: It was first developed as a treatment for B cell lymphoma and has subsequently found use in treating certain autoimmune diseases like rheumatoid arthritis, SLE and pemphigous vulgaris, Churg Strauss syndrome including in those patients with asthma [2] and atopic dermatitis where a significant clinical improvement was associated with only a modest reduction in total circulating IgE [3].