Successful tocilizumab treatment in a patient with adult-onset Still’s disease complicated by chronic active hepatitis B and amyloid A amyloidosis

Vol.21 No.2

Case Report

Successful tocilizumab treatment in a patient with adult-onset Still’s disease complicated by chronic active hepatitis B and amyloid A amyloidosis

Authors

Dai Kishida¹ , Yasuaki Okuda¹ , Makoto Onishi¹ , Masashi Takebayashi¹ , Kenichiro Matoba¹ , Kazuo Jouyama¹ , Akihiro Yamada¹ , Naoya Sawada¹ , Sho Mokuda¹ , Kiyoshi Takasugi¹

Department of Internal Medicine, Center for Rheumatic Diseases, Dohgo Spa Hospital, 21-21 Otsu Dohgo-Himezuka, Matsuyama Ehime, 790-0858, Japan

Received:

14 July 2010

Accepted:

15 September 2010

Published online:

8 October 2010

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Abstract

We report successful tocilizumab (TCZ) use in a patient with adult-onset Still’s disease (AOSD) complicated by chronic hepatitis B (CHB) and AA amyloidosis (AAA). Treatments with corticosteroid and various types of immunosuppressants were unsuccessful. Aggravation of CHB ensued, and entecavir was started. Normalisation of liver function and hepatitis B virus (HBV) DNA were confirmed. TCZ was then started. His arthritis and AAA improved dramatically. TCZ is an excellent treatment for refractory AOSD and is feasible in an HBV-infected patient.

Key words

Adult-onset Still’s disease - Amyloid A amyloidosis - Chronic active hepatitis B - Entecavir - Tocilizumab