SHM Converge Scientific Abstract ePoster Gallery-Ixekizumab Induced Interstitial Lung Disease

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This case report describes a 62-year-old woman with psoriasis who developed drug-induced interstitial lung disease (ILD) while receiving ixekizumab, a biologic agent. She had previously been treated with adalimumab and had started ixekizumab about eight months before presentation.<br /><br />She presented with 5 days of worsening shortness of breath and hypoxia requiring 5 liters of oxygen by nasal cannula. CT angiography showed a right middle lobe lobar pulmonary embolism, right lower lobe subsegmental emboli, bilateral deep vein thromboses, and upper-lobe–predominant pulmonary fibrosis with emphysematous changes. She was initially treated with enoxaparin, empiric antibiotics, and micafungin because of concern for infection in an immunocompromised patient.<br /><br />Despite treatment, she did not improve. COVID-19 testing was repeatedly negative, and an extensive infectious and rheumatologic workup was unrevealing. Flow cytometry excluded lymphoma. Because of high oxygen needs, lung biopsy was deferred. Steroids were then started empirically, leading to marked improvement in oxygen requirements and imaging findings. She was discharged on low-flow oxygen, apixaban, and prophylactic Bactrim, and ixekizumab was stopped. At follow-up, she was nearly back to baseline with oxygen saturation around 95% on room air and significant improvement in dyspnea.<br /><br />The authors emphasize that ILD has many causes, including drugs, and that more than 350 medications have been linked to drug-induced ILD. Ixekizumab-related pulmonary toxicity is uncommon but should be considered when persistent infiltrates and ILD-like findings remain after other causes are excluded. Early recognition, medication review, drug discontinuation, and corticosteroid therapy can lead to substantial recovery.

Asset Subtitle

Omar Al Omari

Meta Tag

Author List Alaaeldin Ahmed, Chinmay Jani, Dipesh Patel, Omar Al Omari, Prateek Khanna, Robert Schiffman

Category Clinical Vignettes

Concept Interstitial Lung Disease

Concept Drug-Induced Lung Injury

Concept Drug-Induced Lung Toxicity

Concept Ixekizumab

Concept Offending Agent

Distinguished Non-Finalist

Presenter Organization Mount Auburn Hospital

Presenting Author Omar Al Omari

Track Adult

Keywords

ixekizumab

drug-induced interstitial lung disease

psoriasis

pulmonary fibrosis

hypoxia

corticosteroid therapy

biologic agent

pulmonary embolism

deep vein thrombosis

drug toxicity

Interstitial Lung Disease

Drug-Induced Lung Injury

Drug-Induced Lung Toxicity

Ixekizumab

Offending Agent