J Rheum Dis.  2019 Oct;26(4):278-281. 10.4078/jrd.2019.26.4.278.

A Case of Rapid Progressive Neurosyphilis in Patient with Ankylosing Spondylitis Who Is Treating Anti-interleukin 17A Monoclonal Antibody, Secukinumab

• Lee SJ
• Park HK
• Kim YS

• KMID: 2459453
• DOI: http://doi.org/10.4078/jrd.2019.26.4.278

Abstract

Anti-interleukin 17A agent, secukinumab is remarkably effective for treating patients with ankylosing spondylitis. However, the main safety concern of secukinumab is an increased risk of infection. Generally, neurosyphilis occurs a few years after the primary syphilitic infection. Rare cases of progressing to neurosyphilis with a much lower latency were reported. We report a case of rapid progressive neurosyphilis involving hearing loss in both ears in a patient with ankylosing spondylitis who was treated with secukinumab.

Keyword

Ankylosing spondylitis; Interleukin 17A; Neurosyphilis

MeSH Terms

Ear
Hearing Loss
Humans
Interleukin-17
Neurosyphilis*
Spondylitis, Ankylosing*
Interleukin-17

Figure

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  Figure 1 Diffuse macula-papular erythematous rash on the palms (A) and anterior trunk (B).

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  Figure 2 Magnetic resonance imaging (MRI) features of neurosyphilis during follow-up. MRI revealed diffuse leptomeningeal enhancement along the interpeduncular cistern of the mesencephalon (midbrain) forming a thin plaque (A) and enhancement of cranial nerve sheath together with (extending toward) inner ear (VII~VIII complex) (B) before treatment. MRI showed an improved lesion of previous meningeal enhancement (C, D) after the seventh day of treatment.

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