Excellent therapeutic effect of tocilizumab on intestinal amyloid a deposition secondary to active rheumatoid arthritis

被引：39

作者：

Inoue, Daichi ^{[1
]}

Arima, Hiroshi ^{[1
]}

Kawanami, Chiharu ^{[2
]}

Takiuchi, Yoko ^{[1
]}

Nagano, Seiji ^{[1
]}

Kimura, Takaharu ^{[1
]}

Shimoji, Sonoko ^{[1
]}

Mori, Minako ^{[1
]}

Tabata, Sumie ^{[1
]}

Yanagita, Soshi ^{[1
]}

Matsushita, Akiko ^{[1
]}

Nagai, Kenichi ^{[1
]}

Imai, Yukihiro ^{[3
]}

Takahashi, Takayuki ^{[1
]}

机构：

[1] Kobe City Med Ctr Gen Hosp, Dept Hematol & Clin Immunol, Chuo Ku, Kobe, Hyogo 6500046, Japan

[2] Kobe City Med Ctr Gen Hosp, Dept Gastroenterol, Chuo Ku, Kobe, Hyogo 6500046, Japan

[3] Kobe City Med Ctr Gen Hosp, Dept Clin Pathol, Chuo Ku, Kobe, Hyogo 6500046, Japan

来源：

CLINICAL RHEUMATOLOGY | 2010年 / 29卷 / 10期

关键词：

Amyloidosis; IL-6; Rheumatoid arthritis; Tocilizumab; AA AMYLOIDOSIS; RECEPTOR ANTIBODY; ETANERCEPT; EFFICACY; PROTEIN;

D O I：

10.1007/s10067-010-1422-6

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 64-year-old woman suffering from progressive amyloid A (AA) amyloidosis of the gastrointestinal (GI) tract, associated with active rheumatoid arthritis, was transferred to our hospital due to hypovolemic shock. Although intensive care, including treatment with prednisolone and methotrexate, improved the hypovolemic shock, paralytic ileus became dominant instead of the marked diarrhea, suggesting the terminal stage of AA amyloidosis of the GI tract. Thus, we administered tocilizumab, a humanized anti-interleukin 6 receptor antibody (8 mg/kg, repeated every 4 weeks). Two weeks after the first injection of tocilizumab, serum AA rapidly returned to their normal ranges in accordance with the amelioration of paralytic ileus and systemic joint pain. Surprisingly, after three courses of tocilizumab treatment, colon biopsy revealed no amyloid deposition. Tocilizumab is a promising agent to treat secondary AA amyloidosis by strongly suppressing serum AA levels.

引用

页码：1195 / 1197

页数：3

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