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.

Boerhaave's syndrome: successful conservative treatment in two patients.

The Boerhaave syndrome is a spontaneous, post-emetic rupture of the esophagus and a rare but potentially fatal cause of upper gastrointestinal bleeding. There are currently no guidelines on the optimal treatment of these patients, although there is a strong tendency towards a surgical approach. We present 2 cases of male patients, 66- and 77-year old respectively, both admitted to the emergency department with hematemesis. Unexpectedly, these turned out to be caused by the Boerhaave syndrome. Based on the severity of presentation, either a conservative or endoscopic treatment was adopted, both with good outcome.