Progressive Multifocal Leukoencephalopathy during Tocilizumab Treatment for Rheumatoid Arthritis.
Antibodies, Monoclonal
/ therapeutic use
Antibodies, Monoclonal, Humanized
/ adverse effects
Arthritis, Rheumatoid
/ drug therapy
Female
Humans
Leukoencephalopathy, Progressive Multifocal
/ chemically induced
Magnetic Resonance Imaging
Methotrexate
/ therapeutic use
Middle Aged
Receptors, Interleukin-6
/ antagonists & inhibitors
IL-6 receptor antibody
magnetic resonance imaging
methotrexate
progressive multifocal leukoencephalopathy
rheumatoid arthritis
tocilizumab
Journal
Internal medicine (Tokyo, Japan)
ISSN: 1349-7235
Titre abrégé: Intern Med
Pays: Japan
ID NLM: 9204241
Informations de publication
Date de publication:
15 Aug 2020
15 Aug 2020
Historique:
pubmed:
26
5
2020
medline:
29
12
2020
entrez:
26
5
2020
Statut:
ppublish
Résumé
A 61-year-old woman was diagnosed with rheumatoid arthritis 12 years ago and received multiple treatment regimens before achieving symptomatic stability with methotrexate plus tocilizumab, a humanized monoclonal antibody against the IL-6 receptor, about 2 years prior to the current presentation. Sixteen months after tocilizumab initiation, she exhibited dysarthria and disorientation; five months later, she was hospitalized with movement difficulties. Her neurological symptoms deteriorated thereafter, accompanied by enlarged cerebral white matter lesions on magnetic resonance imaging. A biopsy of the right frontal lesion confirmed progressive multifocal leukoencephalopathy (PML). While several therapeutic monoclonal antibodies have been linked to PML, this is the first case associated with tocilizumab.
Identifiants
pubmed: 32448834
doi: 10.2169/internalmedicine.4431-20
pmc: PMC7492111
doi:
Substances chimiques
Antibodies, Monoclonal
0
Antibodies, Monoclonal, Humanized
0
Receptors, Interleukin-6
0
tocilizumab
I031V2H011
Methotrexate
YL5FZ2Y5U1
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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