Case ReportOpen Access

Successful use of Ustekinumab in a Patient with Psoriasis, Psoriatic Arthritis and Systemic Lupus Erythematosus: A Case report and Review of literature

Volume 1 - Issue 7

**Aman Kugasia*¹, Ailda Nika¹, Winston Sequeira¹, Joel Block¹, Meenakshi Jolly¹, Chandrahasa Annem² and Palashkumar Jaiswal³**

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- ¹Department of Rheumatology, Rush University Medical Center, USA
- ²Presbyterian Medical Center, Albuquerque, USA
- ³Department of Internal Medicine, John H Stroger Jr. Hospital of Cook County, USA
*Corresponding author: Aman Kugasia, Rush University Medical Center, University Rheumatologist 1611 West Harrison Street, Suit 510, Chicago- IL- 60612

Received: December 07, 2017; Published: December 15, 2017

DOI: 10.26717/BJSTR.2017.01.000597

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Abstract

Studies have demonstrated the role of TH-17 pathway in the pathogenesis of Systemic Lupus Erythematosus (SLE). Ustekinumab, a monoclonal antibody, binds and inhibits p40 subunit of IL-12 and 23, leading to IL-17 blockage, causing inhibition of TH-17 signaling pathway. Ustekinumab has rarely been used in the treatment of SLE. Herein, we discuss a patient with long standing history of Psoriasis and Psoriatic Arthritis, which was successfully being managed with anti TNF therapy. He was later diagnosed to have concomitant SLE. His persistently active and aggressive psoriatic lesions, arthritis and thrombocytopenia posed an interesting therapeutic dilemma. Fortunately his psoriatic lesions, arthritis and thrombocytopenia responded well to ustekinumab. Methotrexate was added to his regimen after improvement and he remained in remission on this therapy. Further clinical studies are warranted to investigate the role of TH-17 blocking agents in SLE.

Keywords: Ustekinumab; Systemic Lupus Erythematosus (SLE); Psoriasis; Thrombocytopenia; IL 17; IL 23

Abbreviations: SLE: Systemic luous erythematosus; CCLE: Chronic Cutaneous Lupus Erythematosus; DLE: Discoid Lupus Erythematosus; PsA: Psoriatic Arthritis; Ps: Psoriasis; TNF: Tumor Necrosis Factor; IL: Interleukin; AIHA: Auto Immune Hemolytic Anemia; PUV-A: Photo Ultraviolet A; Anti Ds-DNA: Anti-Double Stranded Deoxyribonucleic Acid; LAC: Lupus Anticoagulant; Anti RNP: Anti- Ribo Nuclear Protein; Anti Sm: Anti- Smith; MRI: Magnetic Resonance Imaging; Mg: Milligrams