Secukinumab-induced Crohn’s disease in a psoriasis patient: a case report highlighting paradoxical reactions to IL-17 inhibition

Secukinumab, a monoclonal antibody targeting interleukin-17A, is effective for treating moderate-to-severe plaque psoriasis but may induce paradoxical inflammatory bowel disease, particularly Crohn’s disease. We describe a 41-year-old male with a history of psoriasis who developed new-onset Crohn’s...

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Main Authors: Huiling Dai, Chenyi Xu, Yehuang Wang, Kunlan Wu, Yang Zhang, Hao Ge, Yanlan Wu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1628461/full
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author Huiling Dai
Chenyi Xu
Yehuang Wang
Kunlan Wu
Yang Zhang
Hao Ge
Yanlan Wu
author_facet Huiling Dai
Chenyi Xu
Yehuang Wang
Kunlan Wu
Yang Zhang
Hao Ge
Yanlan Wu
author_sort Huiling Dai
collection DOAJ
description Secukinumab, a monoclonal antibody targeting interleukin-17A, is effective for treating moderate-to-severe plaque psoriasis but may induce paradoxical inflammatory bowel disease, particularly Crohn’s disease. We describe a 41-year-old male with a history of psoriasis who developed new-onset Crohn’s disease accompanied by a perianal abscess after prolonged secukinumab treatment. The patient experienced increased bowel movements and postoperative fever, and colonoscopy revealed diffuse colonic inflammation and deep ulcerations; histopathology confirmed chronic active enteritis with epithelioid granulomas. Infectious causes and other differential diagnoses were excluded. Treatment with corticosteroids and mesalamine led to symptom resolution and normalization of inflammatory markers. This case illustrates a rare but important adverse effect of IL-17A inhibition and emphasizes the dual role of IL-17A in promoting skin inflammation while maintaining intestinal homeostasis. Careful evaluation of gastrointestinal history and close monitoring during therapy are essential to prevent and manage potential intestinal complications.
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institution Kabale University
issn 1664-3224
language English
publishDate 2025-07-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Immunology
spelling doaj-art-e0b6fabb7b2a45f59bc9bee21d25d83f2025-08-20T03:50:58ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16284611628461Secukinumab-induced Crohn’s disease in a psoriasis patient: a case report highlighting paradoxical reactions to IL-17 inhibitionHuiling Dai0Chenyi Xu1Yehuang Wang2Kunlan Wu3Yang Zhang4Hao Ge5Yanlan Wu6Colon and Rectal Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, ChinaColon and Rectal Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, ChinaColon and Rectal Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, ChinaColon and Rectal Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, ChinaJiangsu Clinical Innovation Center For Anorectal Diseases of Traditional Chinese Medicine (T.C.M), Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, ChinaSchool of Clinical Medicine, Jiangsu Health Vocational College, Nanjing, ChinaColon and Rectal Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, ChinaSecukinumab, a monoclonal antibody targeting interleukin-17A, is effective for treating moderate-to-severe plaque psoriasis but may induce paradoxical inflammatory bowel disease, particularly Crohn’s disease. We describe a 41-year-old male with a history of psoriasis who developed new-onset Crohn’s disease accompanied by a perianal abscess after prolonged secukinumab treatment. The patient experienced increased bowel movements and postoperative fever, and colonoscopy revealed diffuse colonic inflammation and deep ulcerations; histopathology confirmed chronic active enteritis with epithelioid granulomas. Infectious causes and other differential diagnoses were excluded. Treatment with corticosteroids and mesalamine led to symptom resolution and normalization of inflammatory markers. This case illustrates a rare but important adverse effect of IL-17A inhibition and emphasizes the dual role of IL-17A in promoting skin inflammation while maintaining intestinal homeostasis. Careful evaluation of gastrointestinal history and close monitoring during therapy are essential to prevent and manage potential intestinal complications.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1628461/fullpsoriasissecukinumabperianal abscessCrohn’s diseasedrug-related adverse reactions
spellingShingle Huiling Dai
Chenyi Xu
Yehuang Wang
Kunlan Wu
Yang Zhang
Hao Ge
Yanlan Wu
Secukinumab-induced Crohn’s disease in a psoriasis patient: a case report highlighting paradoxical reactions to IL-17 inhibition
Frontiers in Immunology
psoriasis
secukinumab
perianal abscess
Crohn’s disease
drug-related adverse reactions
title Secukinumab-induced Crohn’s disease in a psoriasis patient: a case report highlighting paradoxical reactions to IL-17 inhibition
title_full Secukinumab-induced Crohn’s disease in a psoriasis patient: a case report highlighting paradoxical reactions to IL-17 inhibition
title_fullStr Secukinumab-induced Crohn’s disease in a psoriasis patient: a case report highlighting paradoxical reactions to IL-17 inhibition
title_full_unstemmed Secukinumab-induced Crohn’s disease in a psoriasis patient: a case report highlighting paradoxical reactions to IL-17 inhibition
title_short Secukinumab-induced Crohn’s disease in a psoriasis patient: a case report highlighting paradoxical reactions to IL-17 inhibition
title_sort secukinumab induced crohn s disease in a psoriasis patient a case report highlighting paradoxical reactions to il 17 inhibition
topic psoriasis
secukinumab
perianal abscess
Crohn’s disease
drug-related adverse reactions
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1628461/full
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