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Novel Presentation of Terminal Ileitis Associated with Secukinumab Therapy
Aciel Ahmed Shaheen1, Ismail Hader1, Zakaria Aqel2
1Department of Internal Medicine, William Beaumont Hospital at Royal Oak, 3535 W. Thirteen Mile Rd, Royal Oak, MI 48073, USA.
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.
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