Autoimmune Hemolytic Anemia in a Patient with Generalized Pustular Psoriasis Treated with Brodalumab: A Case Report.

IF 1.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Nippon Medical School Pub Date : 2025-08-26 DOI:10.1272/jnms.JNMS.2026_93-301

Toru Sugimoto, Yuri Kinoshita, Keigo Ito, Hidehisa Saeki, Azusa Ogita

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Abstract

Psoriasis is a condition characterized by chronic inflammation of the skin, epidermal hyperproliferation, and dysregulated differentiation driven by acceleration of the tumor necrosis factor-alpha/interleukin (IL) -23/IL-17 axis. Herein, we report a case of generalized pustular psoriasis initially managed with etretinate, apremilast, and risankizumab in a Japanese man. Because of side effects, a therapeutic transition was made to brodalumab at 7 months after the initial consultation. His dermatological symptoms improved; however, hemoglobin concentration decreased to 7.6 g/dl after 4 months of treatment. Diagnostic investigation revealed warm autoimmune hemolytic anemia (AIHA). To our knowledge, this is the first report of AIHA during treatment with brodalumab for generalized pustular psoriasis. The etiological association between AIHA and psoriasis is unclear. Future studies should investigate whether AIHA accompanies pustular psoriasis or results from drug-induced AIHA secondary to brodalumab administration. Our findings suggest that the risk of AIHA in patients with psoriasis treated with brodalumab warrants careful consideration.

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布罗达鲁单抗治疗广泛性脓疱性银屑病患者自身免疫性溶血性贫血1例

牛皮癣是一种以皮肤慢性炎症、表皮增生和肿瘤坏死因子- α /白细胞介素(IL) -23/IL-17轴加速驱动的分化失调为特征的疾病。在此，我们报告了一例广泛性脓疱性银屑病，最初用依替酸酯、阿普米司特和瑞尚单抗治疗，患者为日本男性。由于副作用，在首次咨询后7个月改用brodalumab治疗。他的皮肤症状有所改善；然而，治疗4个月后，血红蛋白浓度降至7.6 g/dl。诊断调查显示温热自身免疫性溶血性贫血（AIHA）。据我们所知，这是第一个报道AIHA在治疗广泛性脓疱性银屑病布罗达鲁单抗期间。AIHA与牛皮癣的病因学关系尚不清楚。未来的研究应探讨AIHA是否伴发脓疱性银屑病或继发于布罗达鲁单抗的药物性AIHA的结果。我们的研究结果表明，用brodalumab治疗的银屑病患者发生AIHA的风险值得仔细考虑。

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来源期刊

Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-

CiteScore

1.80

自引率

10.00%

发文量

118

期刊介绍： The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.