-Case Report-

Autoimmune Hemolytic Anemia in a Patient with Generalized Pustular Psoriasis Treated with Brodalumab: A Case Report

Toru Sugimoto¹, Yuri Kinoshita¹, Keigo Ito¹, Hidehisa Saeki² and Azusa Ogita¹

¹Department of Dermatology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
²Department of Dermatology, Nippon Medical School, Tokyo, Japan

Psoriasis is a condition characterized by chronic inflammation of the skin, epidermal hyperproliferation, and dysregulated differentiation driven by acceleration of the tumor necrosis factor-alpha/interleukin (IL)-23/IL-17 axis. Herein, we report a case of generalized pustular psoriasis initially managed with etretinate, apremilast, and risankizumab in a Japanese man. Because of side effects, a therapeutic transition was made to brodalumab at 7 months after the initial consultation. His dermatological symptoms improved; however, hemoglobin concentration decreased to 7.6 g/dL after 4 months of treatment. Diagnostic investigation revealed warm autoimmune hemolytic anemia (AIHA). To our knowledge, this is the first report of AIHA during treatment with brodalumab for generalized pustular psoriasis. The etiological association between AIHA and psoriasis is unclear. Future studies should investigate whether AIHA accompanies pustular psoriasis or results from drug-induced AIHA secondary to brodalumab administration. Our findings suggest that the risk of AIHA in patients with psoriasis treated with brodalumab warrants careful consideration.

J Nippon Med Sch 2026; 93: 269-271

Keywords
generalized pustular psoriasis, interleukin-17, brodalumab, warm autoimmune hemolytic anemia

Correspondence to
Toru Sugimoto
s-toru@nms.ac.jp

Received, November 20, 2024
Accepted, January 15, 2025