Vol.19 No.1

Case Report

Masked early symptoms of pneumonia in patients with rheumatoid arthritis during tocilizumab treatment: a report of two cases

Authors

Hiroshi Fujiwara1 , Norihiro Nishimoto2 , Yoshimasa Hamano1 , Nobuyuki Asanuma1 , Shunji Miki1 , Soji Kasayama1 , Masaki Suemura1

  • Department of General Internal Medicine, Nissay Hospital, 6-3-8 Itachibori, Nishi-ku, Osaka 550-0012, Japan
  • Laboratory of Immune Regulation, Graduate School of Frontier Biosciences, Osaka University, 1-3 Yamada-Oka, Suita, Osaka 565-0871, Japan
Received:

13 April 2008

Accepted:

10 July 2008

Published online:

30 August 2008

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Abstract

Although reports of serious infections in clinical trials for rheumatoid arthritis (RA) with tocilizumab, anti-interleukin6 (IL-6) receptor antibody, have been relatively few, there is still some concern about infections. We report here two cases of patients who developed severe pneumonia during tocilizumab treatment for RA. Both patients initially presented with only minimal clinical symptoms and modest elevations in serum C-reactive protein. Tocilizumab might suppress the early inflammatory symptoms of pneumonia.

Key words

IL-6 - Pneumonia - Rheumatoid arthritis - Symptom - Tocilizumab