Tocilizumab for massive refractory pleural effusion in an adolescent with systemic lupus erythematosus.
IL-6
JSLE (Juvenile-onset Systemic Lupus Erythematosus) - Pleural effusion
Tocilizumab
Journal
Pediatric rheumatology online journal
ISSN: 1546-0096
Titre abrégé: Pediatr Rheumatol Online J
Pays: England
ID NLM: 101248897
Informations de publication
Date de publication:
16 Sep 2021
16 Sep 2021
Historique:
received:
24
06
2021
accepted:
30
08
2021
entrez:
17
9
2021
pubmed:
18
9
2021
medline:
11
2
2022
Statut:
epublish
Résumé
Pleural effusion in systemic lupus erythematous (SLE) is a common symptom, and recent studies demonstrated that IL-6 has a pivotal role in its pathogenesis. We report a case of a 15 years old Caucasian boy with a history of persistent pleural effusion without lung involvement or fever. Microbiological and neoplastic aetiologies were previously excluded. Based on the presence of pleuritis, malar rash, reduction of C3 and C4 levels and positivity of antinuclear antibody (ANA) and anti-double stranded DNA (dsDNA), the diagnosis of juvenile SLE (JSLE) was performed. Treatment with high dose of intravenous glucocorticoids and mycophenolate mofetil was started with partial improvement of pleural effusion. Based on this and on adults SLE cases with serositis previously reported, therapy with intravenous tocilizumab (800 mg every two weeks) was started with prompt recovery of pleural effusion. To the best of our knowledge, this is the first case of JSLE pleuritis successfully treated with tocilizumab.
Sections du résumé
BACKGROUND
BACKGROUND
Pleural effusion in systemic lupus erythematous (SLE) is a common symptom, and recent studies demonstrated that IL-6 has a pivotal role in its pathogenesis.
CASE PRESENTATION
METHODS
We report a case of a 15 years old Caucasian boy with a history of persistent pleural effusion without lung involvement or fever. Microbiological and neoplastic aetiologies were previously excluded. Based on the presence of pleuritis, malar rash, reduction of C3 and C4 levels and positivity of antinuclear antibody (ANA) and anti-double stranded DNA (dsDNA), the diagnosis of juvenile SLE (JSLE) was performed. Treatment with high dose of intravenous glucocorticoids and mycophenolate mofetil was started with partial improvement of pleural effusion. Based on this and on adults SLE cases with serositis previously reported, therapy with intravenous tocilizumab (800 mg every two weeks) was started with prompt recovery of pleural effusion.
CONCLUSION
CONCLUSIONS
To the best of our knowledge, this is the first case of JSLE pleuritis successfully treated with tocilizumab.
Identifiants
pubmed: 34530845
doi: 10.1186/s12969-021-00635-w
pii: 10.1186/s12969-021-00635-w
pmc: PMC8444491
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
tocilizumab
I031V2H011
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
144Informations de copyright
© 2021. The Author(s).
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