Use of biologics in Chinese pregnant patients with deficiency of interleukin-36 receptor antagonist (DITRA): A case series

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2024-05-01 DOI:10.1016/j.tjog.2024.02.001

Chang-Yu Hsieh , Yun-Ju Tsai , Tsen-Fang Tsai

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Abstract

Objective

Impetigo herpetiformis (IH) is a rare form of pustular psoriasis which may result in maternal and fetal morbidity and even mortality. Deficiency of interleukin-36 receptor antagonist (DITRA) is the most frequently identified genetic defect of IH. Currently there are no biologics approved for IH despite the revolutionary role of biologics in the treatment of plaque and pustular psoriasis. Anecdotal reports of biologics use in DITRA patients with IH are also limited.

Case reports

We present herein a case series of 6 Chinese IH patients harboring IL36RN gene c.115+6T>C mutation during 8 pregnancies, treated with various biologics, including adalimumab, etanercept and secukinumab.

Conclusion

Most pregnancy courses were uneventful, except for one woman who had recurrent episodes of decreased fetal heart rate variability after adalimumab injections, which subsided after switching to etanercept. The treatment effectiveness and safety demonstrated in our cases suggested the role of biologics for the treatment of IH in patients with DITRA.

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在白细胞介素-36受体拮抗剂缺乏症（DITRA）的中国孕妇中使用生物制剂：病例系列

目的疱疹性荨麻疹（IH）是一种罕见的脓疱性银屑病，可导致母体和胎儿发病甚至死亡。白细胞介素-36受体拮抗剂（DITRA）缺乏症是最常见的遗传缺陷性荨麻疹。尽管生物制剂在治疗斑块型银屑病和脓疱型银屑病方面发挥了革命性的作用，但目前还没有生物制剂获准用于治疗 IH。关于生物制剂在 DITRA IH 患者中应用的轶事报道也很有限。+结论除了一名孕妇在注射阿达木单抗后反复出现胎儿心率变异性下降，在改用依那西普后症状缓解外，大多数孕妇的妊娠过程都很顺利。我们的病例所显示的治疗效果和安全性表明，生物制剂在治疗DITRA患者的IH方面发挥着重要作用。

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来源期刊

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.

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