Usefulness of Ustekinumab for Treating a Case of Myelodysplastic Syndrome-associated Inflammatory Bowel Disease

Masashi Kono; Toshiharu Sakurai; Kazuki Okamoto; Tomoyuki Nagai; Yoriaki Komeda; Hiroshi Kashida; Kosuke Minaga; Ken Kamata; Mamoru Takenaka; Satoru Hagiwara; Tomohiro Watanabe; Naoshi Nishida; Eisuke Enoki; Hiroaki Inoue; Itaru Matsumura; Masatoshi Kudo

doi:10.2169/internalmedicine.2495-18

CASE REPORTS

Usefulness of Ustekinumab for Treating a Case of Myelodysplastic Syndrome-associated Inflammatory Bowel Disease

Masashi Kono, Toshiharu Sakurai, Kazuki Okamoto, Tomoyuki Nagai, Yoriaki Komeda, Hiroshi Kashida, Kosuke Minaga, Ken Kamata, Mamoru Takenaka, Satoru Hagiwara, Tomohiro Watanabe, Naoshi Nishida, Eisuke Enoki, Hiroaki Inoue, Itaru Matsumura, Masatoshi Kudo

Author information

Masashi Kono
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Toshiharu Sakurai
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Kazuki Okamoto
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Tomoyuki Nagai
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Yoriaki Komeda
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Hiroshi Kashida
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Kosuke Minaga
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Ken Kamata
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Mamoru Takenaka
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Satoru Hagiwara
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Tomohiro Watanabe
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Naoshi Nishida
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
Eisuke Enoki
Department of Pathology, Kindai University Faculty of Medicine, Japan
Hiroaki Inoue
Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Japan
Itaru Matsumura
Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Japan
Masatoshi Kudo
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan

Keywords: MDS, IBD, Crohn's disease, Behçet's disease, ustekinumab

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 14 Pages 2029-2033

DOI https://doi.org/10.2169/internalmedicine.2495-18

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Abstract

Autoimmune diseases including inflammatory bowel disease (IBD) occur in association with myelodysplastic syndrome (MDS). MDS-associated IBD frequently demonstrates a complicated course. We herein report the first case with MDS-associated IBD that was successfully treated with ustekinumab (UST), an anti-interleukin (IL) 12/23p40 monoclonal antibody. A 63-year-old man with a 7-year history of MDS was referred for examination of diarrhea, abdominal pain and fever. A blood examination revealed a marked elevation of C-reactive protein. Colonoscopy showed multiple ulcers in the terminal ileum. He was resistant to anti-tumor necrosis factor (TNF)-α antibody and azacitidine. Subsequently, UST treatment reduced colonic IL-17 and IL-6 expression and the patient currently maintains a state of remission.

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