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

Mod Rheumatol. 2011 Apr;21(2):215-8. doi: 10.1007/s10165-010-0365-8. Epub 2010 Oct 8.

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amyloid / metabolism
  • Amyloidosis / complications
  • Amyloidosis / drug therapy*
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents / therapeutic use*
  • Antiviral Agents / therapeutic use
  • DNA, Viral / analysis
  • Drug Therapy, Combination
  • Guanine / analogs & derivatives
  • Guanine / therapeutic use
  • Hepatitis B virus / drug effects
  • Hepatitis B virus / genetics
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / drug therapy*
  • Humans
  • Male
  • Still's Disease, Adult-Onset / complications
  • Still's Disease, Adult-Onset / drug therapy*
  • Treatment Outcome
  • Viral Load / drug effects

Substances

  • Amyloid
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Antiviral Agents
  • DNA, Viral
  • entecavir
  • Guanine
  • tocilizumab