Possible autoimmune hemolytic anemia induced by secukinumab: a case report

Abstract

Secukinumab, an anti-IL-17 monoclonal antibody, has been used to treat psoriasis and psoriatic arthritis since 2015. Several adverse events were reported, such as diarrhea, upper respiratory tract infection, middle ear infection, and neutropenia. Here we report a probable case of autoimmune hemolytic anemia in a 39 years old male with psoriasis and psoriatic arthritis treated with secukinumab. Hemolytic anemia detected after first maintenance dose after completion of induction dose of secukinumab. The patient also had other comorbids, soft tissue infection that also predisposed to autoimmune hemolytic anemia, but secukinumab is still a possible etiology for drug-induced autoimmune hemolytic anemia based on Naranjo´s score. The patient decided to continue secukinumab treatment, interestingly hemoglobin levels improved.

Keywords: Autoimmune hemolytic anemia; case report; psoriasis; psoriatic arthritis; secukinumab.

Figure 1

possible interaction between anti IL-17 and red blood cells; mature RBC possibly still express IL-17 receptor and binding of IL-17 with antibody to-IL-17 may results in hemolytic response through several mechanism (i.e complement) or probably agglutination; development of anti-drug antibody may possibly initiate agglutination (illustration: Rosandy KO)