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Case Reports
. 2020 Sep 3;3(1):118-120.
doi: 10.1016/j.cjco.2020.08.012. eCollection 2021 Jan.

Ixekizumab-Induced Cardiac Sarcoidosis: A Case Report

Dilara Hatipoglu  1 , Christopher Tanski  2 , Rory Hachamovitch  3 , Sapna Legha  4 , Rohit Moudgil  4
Affiliations
Case Reports

Ixekizumab-Induced Cardiac Sarcoidosis: A Case Report

Dilara Hatipoglu et al. CJC Open. .

Abstract
in English, French

A 58-year-old man with a history of hypertension and psoriasis presented with acute-onset heart failure with an ejection fraction of 25%-30%. During the work-up, cardiac magnetic resonance imaging showed a pattern of inflammation consistent with sarcoidosis, which was confirmed with (18)F-fluorodeoxyglucose positron emission tomography . The patient was recently initiated on ixekizumab for psoriasis, which was then discontinued. This discontinuation resulted in complete resolution of cardiac sarcoidosis, with establishment of normal ejection fraction. This result suggests a potential causal association of ixekizumab-induced cardiac sarcoidosis, which is a rare phenomenon. Elucidation of the mechanism behind the effect of ixekizumab may provide insights into the possible mechanism(s) behind cardiac sarcoidosis.

Nous exposons le cas d’un homme de 58 ans ayant des antécédents d’hypertension et de psoriasis qui a présenté une insuffisance cardiaque d’apparition soudaine avec fraction d’éjection de 25 à 30 %. À l’investigation, l’imagerie par résonance magnétique cardiaque a révélé une inflammation évocatrice d’une sarcoïdose, un diagnostic qui a été confirmé par tomographie par émission de positons au 18F-fluorodésoxyglucose. Le patient avait récemment commencé un traitement par l’ixékizumab contre le psoriasis, qui a par la suite été abandonné. La sarcoïdose cardiaque est complètement disparue à l’arrêt de ce médicament, et la fraction d’éjection est redevenue normale. Ce résultat indique qu’il pourrait y avoir un lien de causalité entre l’ixékizumab et l’apparition d’une sarcoïdose cardiaque, un phénomène somme toute rare. L’élucidation du mode d’action de l’ixékizumab pourrait fournir des pistes pour expliquer les mécanismes à l’origine de la sarcoïdose cardiaque.

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Figures

Figure 1
Figure 1
(A) Studies performed to rule out non-ischemic cardiomyopathy. (B) Gadolinium contrast magnetic resonance imaging. Cross-sectional imaging of the myocardium shows mid-wall fibrosis (B,C) with predominance of enhancement in basal septal region (as indicated by white arrows). AFB, acid-fast bacillus; ANA, antinuclear antibody; EBV, Epstein-Barr virus; HIV, human immunodeficiency virus; Tb, tuberculosis; TIBC, total iron binding capacity; TSH, thyroid-stimulating hormone.
Figure 2
Figure 2
(A) Positron emission tomography (PET) scan with rest and (18)F-fluorodeoxyglucose positron emission tomography (FDG) uptake. PET scan showed illumination of FDG in the basal anteroseptal segment, basal inferolateral segment, basal anterolateral segment, and basal anterior segment indicating inflammation. The area of interest is marked with red arrows. (B) PET scan with FDG uptake: No discernable FDG uptake can be seen in these images.
See this image and copyright information in PMC

References

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