Volume 87 - 2024 - Fasc.3 - Case series
New onset inflammatory bowel disease after initiation of anti-IL-17a treatment: a case series
Immune mediated inflammatory diseases (IMIDs) are a
heterogenous group of inflammatory disorders of joint, skin,
and gut characterized by both shared and distinct pathological
pathways. This complexity has therapeutic implications, as not all
IMIDs exhibit responsiveness to available biologicals. Moreover,
cases have been documented where patients undergoing biologic
therapy experience paradoxical occurrences of either a new IMID
or a flare-up of a previously asymptomatic one. Treatment with anti-
IL-17a has been approved for ankylosing spondylitis, psoriasis, and
psoriatic arthritis, but was not found effective for the treatment
of inflammatory bowel disease (IBD). This case series describes
four patients with new onset IBD under treatment with an IL-17a
inhibitor for a rheumatological or dermatological indication.
Signet ring cells in the gastrointestinal tract: not always what it seems
We describe two cases of pseudo-signet ring cells in gastric
biopsies of otherwise asymptomatic adult patients. One male patient
was diagnosed during follow-up of a previous intestinal type gastric
adenocarcinoma and underwent surgery before recognition of this
non-malignant entity. He suffered from a secondary anastomotic
stenosis requiring dilatation. A second male patient was spared
from surgery thanks to timely recognition by the pathologist and
is still declared cancer-free until today. This extremely rare nonmalignant
mimicker of cancerous signet ring cells, as seen in diffuse
type gastric cancer can potentially mislead the clinician. The
absence of any endoscopic abnormality should prompt a revision
by an experienced pathologist, digestive oncologist and surgeon to
avoid unnecessary interventions and morbidity. (
