Concurrent Management of Crohn's Ileitis and Alopecia Universalis With Upadacitinib

This case report discusses a 23-year-old man with concurrent Crohn's ileitis and alopecia universalis, who showed significant improvement with the JAK1 inhibitor upadacitinib. The patient, with a history of neonatal ileal atresia and chronic diarrhea, was diagnosed with Crohn's disease (CD) after colonoscopy revealed ulcerations in the neo-terminal ileum. He also had alopecia areata (AA) since age 16, which progressed to alopecia universalis. Treatment with upadacitinib led to hair regrowth on the scalp, eyebrows, and eyelashes within a month, and improvement in CD symptoms and ileum ulcerations. This case underscores the potential of upadacitinib as a therapeutic option for managing both AA and CD, highlighting the shared autoimmune pathway and the need for screening AA patients for IBD symptoms.