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银屑病患者使用白细胞介素-17 抑制剂加重克罗恩病:病例报告。

Crohn's disease exacerbated by IL-17 inhibitors in patients with psoriasis: a case report.

机构信息

Department of Gastroenterology, Shanghai Tenth People's Hospital of Tongji University, No. 301 Yanchang Road, Shanghai, 200072, China.

Department of Pathology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.

出版信息

BMC Gastroenterol. 2020 Oct 15;20(1):340. doi: 10.1186/s12876-020-01474-x.

Abstract

BACKGROUND

Previous studied revealed that psoriasis and Inflammatory bowel disease (IBD) have highly overlapping epidemiological characteristics, genetic susceptibility loci, disease risk factors, immune mechanisms, and comorbidities. More and more biologics have been used to treat psoriasis and IBD. Interleukin (IL)-17 inhibitors played an important role in the treatment of psoriasis, but induced and aggravated inflammatory bowel disease in some patients. IL-23 inhibitors have shown to be effective to both psoriasis and CD.

CASE PRESENTATION

Forty-one year old Chinese male patient who came to the hospital for psoriasis, developed severe gastrointestinal symptoms after using an IL-17 inhibitor, and was diagnosed with Crohn's disease (CD). The patient eventually used an IL-23 inhibitor to relieve both psoriasis and CD.

CONCLUSION

IBD patients and psoriasis patients have increased probability of suffering from the other disease. The case that patients had suffered from psoriasis and CD before the use of IL-17 inhibitor is quite rare. This case suggests that physicians need to be careful when treating patients with psoriasis and CD with biologics, and it is necessary to evaluate the gastrointestinal tract.

摘要

背景

既往研究显示,银屑病和炎症性肠病(IBD)具有高度重叠的流行病学特征、遗传易感性位点、疾病风险因素、免疫机制和合并症。越来越多的生物制剂被用于治疗银屑病和 IBD。白细胞介素(IL)-17 抑制剂在银屑病治疗中发挥了重要作用,但在一些患者中会诱导和加重炎症性肠病。IL-23 抑制剂已被证明对银屑病和 CD 均有效。

病例介绍

一名 41 岁的中国男性患者因银屑病来院就诊,使用 IL-17 抑制剂后出现严重胃肠道症状,被诊断为克罗恩病(CD)。患者最终使用 IL-23 抑制剂缓解了银屑病和 CD。

结论

IBD 患者和银屑病患者患另一种疾病的概率增加。该病例提示,在使用生物制剂治疗银屑病和 CD 患者时,医生需要谨慎,并对胃肠道进行评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8410/7560304/e5cd4542f360/12876_2020_1474_Fig1_HTML.jpg

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