{"title":"Novel Presentation of Terminal Ileitis Associated with Secukinumab Therapy.","authors":"Aciel Ahmed Shaheen, Ismail Hader, Zakaria Aqel","doi":"10.1155/2021/5213876","DOIUrl":null,"url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) and psoriasis are chronic inflammatory immune-mediated diseases. The interleukin-23- (IL23-) T helper (Th)17 pathway has been implicated in their pathogenesis, with multiple biologic therapies targeting this pathway. IL-17, the main proinflammatory cytokine produced by (TH)17, has been targeted by antibodies and IL-17 receptor blockers with favorable outcomes in treating psoriasis and psoriatic arthritis. However, their role in IBD is unpredictable as studies reported worsening of IBD with agents targeting IL-17 and rare case reports with new-onset IBD. We present a case of Crohn's-like severe terminal ileitis and worsening diverticulitis complicated by intestinal perforation requiring total parenteral nutrition shortly after being started on secukinumab.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2021 ","pages":"5213876"},"PeriodicalIF":0.6000,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492294/pdf/","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Gastrointestinal Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2021/5213876","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 1
Abstract
Inflammatory bowel disease (IBD) and psoriasis are chronic inflammatory immune-mediated diseases. The interleukin-23- (IL23-) T helper (Th)17 pathway has been implicated in their pathogenesis, with multiple biologic therapies targeting this pathway. IL-17, the main proinflammatory cytokine produced by (TH)17, has been targeted by antibodies and IL-17 receptor blockers with favorable outcomes in treating psoriasis and psoriatic arthritis. However, their role in IBD is unpredictable as studies reported worsening of IBD with agents targeting IL-17 and rare case reports with new-onset IBD. We present a case of Crohn's-like severe terminal ileitis and worsening diverticulitis complicated by intestinal perforation requiring total parenteral nutrition shortly after being started on secukinumab.
炎症性肠病(IBD)和牛皮癣是慢性炎症免疫介导的疾病。白细胞介素-23- (il -23)辅助性T细胞(Th)17通路与其发病机制有关，多种生物疗法针对该通路。IL-17是(TH)17产生的主要促炎细胞因子，已被抗体和IL-17受体阻滞剂靶向治疗银屑病和银屑病关节炎，效果良好。然而，它们在IBD中的作用是不可预测的，因为研究报告了靶向IL-17的IBD恶化和罕见的新发IBD病例报告。我们报告了一例克罗恩样严重终末回肠炎和恶化憩室炎并发肠穿孔，在开始使用secukinumab后不久需要全肠外营养。
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