{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T22:13:52Z","timestamp":1784931232245,"version":"3.55.0"},"reference-count":21,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>A 35-year-old man with a late-onset combined immunodeficiency (LOCID) variant of common variable immunodeficiency, severe plaque psoriasis, psoriatic arthritis, and Crohn\u2019s disease was attended in the Regional Hospital of Presidente Prudente and HC-FMUSP, S\u00e3o Paulo, Brazil. Anti-IL-12\/IL-23 (ustekinumab) monoclonal antibody was prescribed due to the failure of other treatments (phototherapy, oral acitretin) for psoriasis and a Psoriasis Area Severity Index &gt;10. We evaluated the impact of treatment with ustekinumab on severe infectious diseases in a patient with uncontrolled psoriasis and LOCID followed for 8 years. Four quarterly doses of ustekinumab 90 mg and human immunoglobulin replacement (10,000 mg at 28-day intervals) were administered. Immunophenotyping, cultures of lymphocytes, genetic sequencing, and whole exome sequencing were performed to investigate the primary immunodeficiency. Normal lymphocyte proliferation; pathogenic variants in genetic sequencing, and clinically significant variants in the whole exome for primary immunodeficiencies were not detected. The main infections before and after treatment with ustekinumab were chronic sinusitis and gastroenteritis. The patient was infected with COVID-19, dengue (twice) and influenza and was hospitalized three times for intravenous antibiotic therapy. Ustekinumab did not influence the susceptibility of the patient with LOCID to severe infections and significantly improved psoriasis, psoriatic arthritis, and Crohn\u2019s disease.<\/jats:p>","DOI":"10.3390\/pathogens12091156","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T21:34:12Z","timestamp":1694554452000},"page":"1156","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Treatment with Ustekinumab on Severe Infections in a Patient with Uncontrolled Psoriasis and Late-Onset Combined Primary Immunodeficiency: Case Report"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4577-1525","authenticated-orcid":false,"given":"Luiz Euribel","family":"Prestes-Carneiro","sequence":"first","affiliation":[{"name":"Immunodeficiencies and Infectious Diseases Outpatient Clinic, Faculty of Medicine, Oeste Paulista University, Presidente Prudente 19.050-920, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilda Aparecida Milanez Morgado","family":"de Abreu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Oeste Paulista University, Presidente Prudente 19.050-920, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2149-2388","authenticated-orcid":false,"given":"Eduardo Vinicius Mendes","family":"Roncada","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Oeste Paulista University, Presidente Prudente 19.050-920, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0091-7698","authenticated-orcid":false,"given":"Diego Garcia","family":"Muchon","sequence":"additional","affiliation":[{"name":"Immunodeficiencies and Infectious Diseases Outpatient Clinic, Faculty of Medicine, Oeste Paulista University, Presidente Prudente 19.050-920, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3358-3567","authenticated-orcid":false,"given":"Fernanda Miranda","family":"Caliani","sequence":"additional","affiliation":[{"name":"Immunodeficiencies and Infectious Diseases Outpatient Clinic, Faculty of Medicine, Oeste Paulista University, Presidente Prudente 19.050-920, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3930-3354","authenticated-orcid":false,"given":"Dewton Moraes","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Investigation Unit 56, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (HC-FMUSP), S\u00e3o Paulo 05403 000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s13223-018-0290-5","article-title":"Primary immunodeficiency","volume":"14","author":"McCusker","year":"2018","journal-title":"Allergy Asthma Clin. 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