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