Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China.
Lupus. 2024 May;33(6):644-649. doi: 10.1177/09612033241242698. Epub 2024 Apr 3.
The interleukin (IL)-17 axis is involved in many inflammatory and autoimmune diseases. Secukinumab, an IL-17 inhibitor, has been approved for psoriasis treatment. There are accumulating cases of lupus erythematosus induced by IL-17 inhibition. Lupus nephritis after IL-17 inhibition has not been reported. We report the case of a 57-year-old man who developed membranous lupus nephritis after secukinumab treatment for psoriasis. Anti-SSA and PM-Scl antibodies were positive. dsDNA, anti-Smith, and anti-histone antibodies were negative, and serum complement was low. Secukinumab was discontinued, while tacrolimus was initiated, subsequently switched to cyclosporin, belimumab, glucocorticosteroid, and hydroxychloroquine with a good response. The relationship between lupus erythematosus and IL-17 inhibition requires further research.
白细胞介素 (IL)-17 轴参与许多炎症和自身免疫性疾病。IL-17 抑制剂司库奇尤单抗已被批准用于治疗银屑病。越来越多的病例报告显示，IL-17 抑制会导致狼疮。但 IL-17 抑制后发生狼疮肾炎尚未见报道。我们报告了一例 57 岁男性患者，在使用司库奇尤单抗治疗银屑病后发生膜性狼疮肾炎。抗 SSA 和 PM-Scl 抗体阳性，dsDNA、抗 Smith 抗体和抗组蛋白抗体阴性，血清补体降低。停用司库奇尤单抗，开始使用他克莫司，随后转换为环孢素、贝利尤单抗、糖皮质激素和羟氯喹，病情缓解良好。狼疮与 IL-17 抑制之间的关系需要进一步研究。
