Late reaction to ustekinumab infusion

Morais, Marina Resener de; Meneghello, Luana Pizarro; Oliveira, Carina Flores de; Carvalho, André Vicente Esteves de

doi:10.4081/dr.2013.e2

Cited by 3 publications

(2 citation statements)

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“…Very rarely, approximately <1% in patients with psoriasis and psoriatic arthritis, urticaria is reported [ 5 ]. Only six previous cases of urticaria have been found in the literature [ 10 , 11 ]. The patient in this report also has hepatitis C, a disease long known to have multiple skin manifestations and is a significant cause of urticaria [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Urticarial Reaction to Ustekinumab During the Treatment of Plaque Psoriasis in a Hepatitis C-Positive Patient

Chu

Davis

2017

Drug Saf - Case Rep

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A 62-year-old white woman with a history of hepatitis C and type 2 diabetes mellitus developed urticaria during treatment with ustekinumab for plaque psoriasis. The patient received two 45-mg ustekinumab injections in her first 2 months and then one 45-mg injection every 3 months for her psoriasis. After 10 months, she developed a round red rash on her skin diffusely on her body. She also complained of joint pain in her hands. Rheumatology became involved, and investigations revealed that her antinuclear antibody titer was negative, but her rheumatoid factor, erythrocyte sedimentation rate, and liver function enzymes were elevated. She was diagnosed with urticaria, and ustekinumab was discontinued. A Naranjo assessment score of 6 was obtained, indicating a probable relationship between the patient’s urticaria and her use of ustekinumab. Ustekinumab was subsequently discontinued, and the patient received a course of Harvoni® (Gilead Sciences, Inc., Forest City, California, United States) (ledispasvir/sofosbuvir) with clearance of the hepatitis C virus. The patient is currently receiving another biologic agent, ixekizumab, and reports no complaints, including that of urticaria.

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Section: Discussionmentioning

confidence: 99%

Urticarial Reaction to Ustekinumab During the Treatment of Plaque Psoriasis in a Hepatitis C-Positive Patient

Chu

Davis

2017

Drug Saf - Case Rep

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“…Common side effects of ustekinumab include infections, allergic reactions, and gastrointestinal upset. Rarely, it can lead to delayed cutaneous reactions [2]. Previously reported cases had suggested a possible correlation between the administration of ustekinumab and the development of non-caseating granulomas in different organs.…”

Section: Introductionmentioning

confidence: 99%

Sarcoid- like Phenomenon - ustekinumab induced granulomatous reaction mimicking diffuse metastatic disease: a case report and review of the literature

et al. 2019

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Background The utilization of monoclonal antibodies has become more widespread over the past decade. However, the development of non-caseating granulomas with the use of monoclonal antibodies, such as ustekinumab, is not widely reported in the literature. Case presentation We report a case of a 50-year-old Caucasian male who presented complaining of weight loss and shortness of breath. He was receiving ustekinumab for refractory psoriasis but had no other significant medical comorbidities. On physical examination, reduced breath sounds on the right side were noted. Blood cultures were drawn on presentation and came back negative in 48 hours. A chest computed tomography scan revealed a large right lung mass in addition to right-sided pleural effusion. Therapeutic thoracocentesis was done; fluid cytology and analysis were negative for malignancy, acid-fast bacilli, or fungal infections. A positron emission tomography scan showed multifocal radiotracer uptake including within right lung mass, multiple bones, lymph nodes, liver and spleen. Biopsies showed hyalinized non-necrotizing granulomas. Immunohistochemical stains for AE1/AE3, cytokeratin 7 and 20, and thyroid transcription factor 1, were all negative. He was started on steroid therapy, and ustekinumab was discontinued and the follow-up computed tomography after a few months showed substantial improvement. However, over the course of next 4 months patient developed hepatic dysfunction and recurrent ascites and ultimately underwent transjugular intrahepatic portosystemic shunt placement. Furthermore, he was started on azathioprine and steroids were tapered. He improved clinically and was discharged from our hospital within a week. Conclusions This case highlights the need for careful consideration of patient medication history while evaluating the possible differential diagnoses that may contribute to a patient’s presentation.

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Ustekinumab

2015

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Late reaction to ustekinumab infusion

Cited by 3 publications

References 10 publications

Urticarial Reaction to Ustekinumab During the Treatment of Plaque Psoriasis in a Hepatitis C-Positive Patient

Urticarial Reaction to Ustekinumab During the Treatment of Plaque Psoriasis in a Hepatitis C-Positive Patient

Sarcoid- like Phenomenon - ustekinumab induced granulomatous reaction mimicking diffuse metastatic disease: a case report and review of the literature

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