A Therapeutic Tightrope: Managing Coexisting Crohn Disease and Systemic Lupus Erythematosus With Risankizumab

The coexistence of systemic lupus erythematosus (SLE) and Crohn disease (CD) is rare and presents significant diagnostic and therapeutic challenges due to overlapping clinical, radiologic, and histologic features. We present a 24-year-old woman with SLE, chronic immune thrombocytopenic purpura, and newly diagnosed CD treated with risankizumab, an interleukin-23 inhibitor approved for CD. She achieved complete clinical and radiologic remission of CD without SLE flares over 12 months. To the best of our knowledge, this represents the first documented case of risankizumab successfully used in a patient with SLE and CD. Further research is needed to assess the long-term safety and wider applicability of interleukin-23 inhibitors for this underserved patient population.