Document Detail

Tocilizumab dramatically ameliorated life-threatening diarrhea due to secondary amyloidosis associated with rheumatoid arthritis.
MedLine Citation:
PMID:  19437089     Owner:  NLM     Status:  MEDLINE    
Severe diarrhea improved dramatically with administration of the humanized anti-interleukin-6 receptor antibody tocilizumab (TCZ) in a patient with secondary reactive amyloidosis, which was associated with rheumatoid arthritis (RA). A 53-year-old woman with RA went into hypovolemic shock because of severe watery diarrhea associated with gastrointestinal amyloidosis. The high-dose prednisolone therapy and glucocorticoid pulse therapy did not improve her intractable diarrhea. After TCZ administration, the life-threatening diarrhea lessened in about 6 h, and her vital signs became stable the next day. Perforation of the small intestine, however, occurred 2 days after TCZ administration. Whether TCZ could have been involved in the perforation in such a short time is unknown. Surgery was successful, and the patient recovered. TCZ may work immediately in diarrhea associated with secondary amyloidosis.
Hiroe Sato; Takehito Sakai; Toshiaki Sugaya; Yasuhiro Otaki; Kana Aoki; Katsushi Ishii; Hidehiro Horizono; Hiroshi Otani; Asami Abe; Noboru Yamada; Hajime Ishikawa; Kiyoshi Nakazono; Akira Murasawa; Fumitake Gejyo
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-05-13
Journal Detail:
Title:  Clinical rheumatology     Volume:  28     ISSN:  1434-9949     ISO Abbreviation:  Clin. Rheumatol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-05     Completed Date:  2009-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211469     Medline TA:  Clin Rheumatol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1113-6     Citation Subset:  IM    
Department of Rheumatology, Niigata Rheumatic Center, Shibata City, Niigata 957-0054, Japan.
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MeSH Terms
Amyloidosis / complications*,  pathology
Antibodies, Monoclonal / administration & dosage*
Arthritis, Rheumatoid / complications*
Diarrhea / drug therapy*,  etiology*,  pathology
Intestinal Mucosa / pathology
Receptors, Interleukin-6 / immunology
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Receptors, Interleukin-6; 0/tocilizumab

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