Rapid Onset of Inflammatory Bowel Disease after Receiving Secukinumab Infusion

Abstract

Secukinumab, an interleukin (IL)-17A antagonist, was associated with disease exacerbations in Crohn's disease, and de novo cases of inflammatory bowel disease (IBD) have been reported in studies of rheumatoid diseases. However, there has been no detailed report demonstrating the linkage between secukinumab therapy and new-onset IBD. We present a unique case of rapid-onset fulminant colitis after receiving 1 dose of secukinumab infusion followed by improvement with combination antibiotics, corticosteroids, and calcineurin inhibition. Health care providers should be aware of the possible association between IL-17 antagonist therapy and the risk of developing new-onset fulminant IBD.

Figure 1

(A) Congested friable mucosa in the distal sigmoid colon. (B) Several deep ulcers and edema seen in the proximal sigmoid colon.

Figure 2

(A) Cryptitis seen on the biopsy of the sigmoid colon. (B) Erosions and severe infiltration of lymphoplasmacytic cells, consistent with chronic active colitis (20× magnification).