Tocilizumab-induced Transaminitis in a Seropositive Rheumatoid Arthritis Patient with Macrophage Activation Syndrome.
10.12771/emj.2016.39.1.23
- Author:
Byung Woo YOO
1
;
Cheol Keun PARK
;
Hae Ryong YUN
;
Daehoon KIM
;
Soo Kon LEE
;
Sang Won LEE
Author Information
1. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. sangwonlee@yuhs.ac
- Publication Type:Case Report
- Keywords:
Rheumatoid arthritis;
Tocilizumab;
Liver toxicity
- MeSH:
Antirheumatic Agents;
Arthritis, Rheumatoid*;
Drug Eruptions;
Humans;
Interleukin-6;
Liver;
Lung Neoplasms;
Macrophage Activation Syndrome*;
Macrophage Activation*;
Macrophages*;
Methotrexate;
Prednisolone;
Sulfasalazine;
Tacrolimus;
Tranexamic Acid*
- From:The Ewha Medical Journal
2016;39(1):23-27
- CountryRepublic of Korea
- Language:English
-
Abstract:
As a new humanized monoclonal antibody against the interleukin-6 receptor, tocilizumab is currently used for the treatment of rheumatoid arthritis (RA) patients. Tocilizumab was reported to provoke drug-related liver toxicity, although there have been no reports on significant liver toxicity from tocilizumab in Korean patients with RA to date. Here, we describe the first case of tocilizumab-related liver toxicity in a patient with complicated RA, accompanied with macrophage activation syndrome, who had received tacrolimus and prednisolone and in whom both conventional disease modifying anti-rheumatic drugs, including methotrexate, leflunomide and sulfasalazine or tumor necrotizing factor-alpha blockades, were contraindicated due to drug eruption and a history of lung cancer.