Toxoplasmosis in a patient receiving ixekizumab for psoriasis

Abstract

The advent of biologic therapies has greatly improved outcomes for patients with debilitating immune-mediated inflammatory diseases. Complications that have arisen from biologic use include infections by opportunistic pathogens. Toxoplasma infection is usually asymptomatic in immunocompetent hosts, and when symptoms do occur, lymphadenopathy is the most common presentation. In immunocompromised hosts, toxoplasmosis is usually a result of reactivation of a dormant infection and is associated with high mortality rates.1,2 It commonly manifests as meningoencephalitis or disseminated infection.2 To the best of our knowledge, only 1 case of toxoplasmosis in a psoriatic patient has been documented.3 Several cases of toxoplasmosis have been reported in nonpsoriatic cohorts after treatment with tumor necrosis factor-α inhibitors.4,5 The association between ixekizumab, an anti-interleukin 17A monoclonal antibody, and the development of toxoplasmosis in psoriatic patients has not been clearly established. We herein describe a case of toxoplasmosis in a 34-year-old health care worker receiving ixekizumab for chronic plaque psoriasis after 20 months of treatment.