Haidari Wasim, Al-Naqshabandi Sarah, Ahn Christine S, Bloomfeld Richard S, Feldman Steven R
Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
SAGE Open Med Case Rep. 2019 Dec 6;7:2050313X19893580. doi: 10.1177/2050313X19893580. eCollection 2019.
IL-17 antagonism is among the most potent treatments for psoriasis. Generally safe, new onset and exacerbations of inflammatory bowel disease may occur in association with IL-17 therapy. We describe a patient with long-standing history of psoriasis and psoriatic arthritis in whom asymptomatic Crohn's disease was identified during treatment with secukinumab. The patient underwent an elective colonoscopy for colorectal cancer screening which revealed inflammation and multiple ulcers in the terminal ileum suggestive of Crohn's disease. While the patient did not have any gastrointestinal symptoms, he was diagnosed as having asymptomatic Crohn's disease. Given the association of inflammatory bowel disease with secukinumab treatment, secukinumab was discontinued. Although in this patient, Crohn's disease was identified during treatment with secukinumab, a direct causal relationship cannot be assumed. Medications that are effective for both psoriasis and inflammatory bowel disease may be a good choice in patients with psoriasis who have comorbid Crohn's disease or develop inflammatory bowel disease during treatment with another biologic.
白细胞介素-17拮抗剂是治疗银屑病最有效的方法之一。通常较为安全，但炎症性肠病的新发和加重可能与白细胞介素-17治疗相关。我们描述了一名有长期银屑病和银屑病关节炎病史的患者，在使用司库奇尤单抗治疗期间发现了无症状克罗恩病。该患者为进行结直肠癌筛查接受了择期结肠镜检查，结果显示回肠末端有炎症和多处溃疡，提示克罗恩病。虽然该患者没有任何胃肠道症状，但他被诊断为患有无症状克罗恩病。鉴于炎症性肠病与司库奇尤单抗治疗的关联，停用了司库奇尤单抗。尽管在该患者中，克罗恩病是在使用司库奇尤单抗治疗期间被发现的，但不能假定存在直接因果关系。对银屑病和炎症性肠病均有效的药物，对于患有合并克罗恩病或在使用另一种生物制剂治疗期间发生炎症性肠病的银屑病患者可能是一个不错的选择。
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