Diffuse Lupus Nephritis Secondary to Ixekizumab Therapy: A Case Report and Literature Review

Introduction: Drug-induced lupus (DIL) is a recognized category of illnesses associated with lupus. There are no standards for diagnosis, DIL differs from the conventional form of SLE in several ways, one of which being the pattern of organ involvement. DIL is often accompanied by constitutional and cutaneous symptoms. Renal system involvement is rare. Management usually is by stopping the offending agent. Up to date several drugs have been identified as being linked in DIL, the introduction of novel medications and the relative decline in the usage of more traditional ones have altered the epidemiology of DIL Case Description: 69-year-old woman who developed diffuse lupus nephritis after receiving ixekizumab for psoriasis. She exhibited symptoms of lower limb edema and uncontrolled hypertension, and was found to have impaired renal function, positive ANA, anti-double strand DNA antibody , anti-ribonucleoprotein antibodies, significant proteinuria, hypoalbuminemia, and low serum complement levels. Ixekizumab was discontinued, and she was treated with prednisolone and mycophenolic acid, resulting in a favorable clinical and laboratory response as shown in figure 1. Discussion: There is a growing number of reported cases of lupus erythematosus induced by IL-17 inhibition. Ixekizumab, an IL-17 inhibitor, are approved for the treatment of active psoriatic arthritis and Ankylosing spondylitis. Lupus nephritis after IL-17 inhibition is not well known or documented as a possible adverse effect, it has been reported before only once after secukinumab therapy (another anti-IL17). To our knowledge this is the the first reported case of drug induced lupus nephritis due to Ixekuzumab.The relationship between IL-17 inhibitors and lupus nephritis not yet well established and Further research are needed.