Efficacy of secukinumab in Takayasu arteritis with myocardial infarction complicated with generalized pustular psoriasis: A case report.

IF 1.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL Medicine Pub Date : 2024-12-20 DOI:10.1097/MD.0000000000040994

Tomoyuki Asano, Shuhei Yoshida, Naoki Matsuoka, Masato Ishikawa, Akihiko Sato, Shotaro Ogawa, Kenji Saito, Yuya Sumichika, Haruki Matsumoto, Jumpei Temmoku, Yuya Fujita, Shuzo Sato, Yasuchika Takeishi, Toshiyuki Yamamoto, Kiyoshi Migita

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Abstract

Rationale: Takayasu arteritis (TAK) is an autoimmune disease that causes chronic inflammation targeting the aortic wall. Since many patients are resistant to steroid treatment, multiple immunosuppressants or interleukin-6 (IL-6) suppression therapy have served as treatment alternatives. However, there are very few reports on the effectiveness of biologics against inflammatory cytokines upstream of IL-6.

Patient concerns: We present a case of TAK in a 51-year-old female presenting with a myocardial infarction. She had persistent carotid wall thickening despite glucocorticoid (GC) therapy, and IL-6 suppression therapy was being proactively considered. While the GC was being tapered, widespread pustules appeared all over her body.

Diagnosis: TAK complicated with generalized pustular psoriasis (GPP).

Interventions: Aside from GC, the patient was treated with secukinumab (SEC), an anti-IL-17A monoclonal antibody.

Outcomes: Immediately after treatment with SEC, the pustules disappeared, and the thickening of the common carotid artery wall improved on ultrasound.

Lessons: Since IL-17 is an important cytokine in the pathogenesis of TAK, anti-cytokine therapy targeting IL-17 may be effective for TAK.

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secukinumab治疗高松动脉炎合并心肌梗死并发广泛性脓疱性银屑病1例

理由：高松动脉炎（takasu arteritis， TAK）是一种自身免疫性疾病，引起以主动脉壁为目标的慢性炎症。由于许多患者对类固醇治疗有耐药性，多种免疫抑制剂或白细胞介素-6 （IL-6）抑制治疗已被作为治疗选择。然而，关于生物制剂对IL-6上游炎症细胞因子的有效性的报道很少。患者关注：我们提出一例51岁的女性TAK，表现为心肌梗死。尽管使用糖皮质激素（GC）治疗，她仍有持续的颈动脉壁增厚，正在积极考虑IL-6抑制治疗。当GC逐渐变细时，她全身出现了广泛的脓疱。诊断：TAK合并广泛性脓疱性银屑病（GPP）。干预措施：除了GC，患者接受了secukinumab （SEC）治疗，这是一种抗il - 17a单克隆抗体。结果：经SEC治疗后，脓疱立即消失，超声显示颈总动脉壁增厚改善。结论：IL-17是TAK发病过程中重要的细胞因子，针对IL-17的抗细胞因子治疗可能对TAK有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medicine 医学-医学：内科

CiteScore

2.80

自引率

0.00%

发文量

4342

审稿时长

>12 weeks

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