title: Leukoencephalopathy with cognitive impairment following tocilizumab for the treatment of rheumatoid arthritis (RA).
abstract: The biological agent tocilizumab, is a humanized, anti-human interleukin-6 receptor antibody. A 72-year-old woman developed cognitive impairment during the Phase III clinical trial of tocilizumab for the treatment of rheumatoid arthritis. MRI demonstrated hyperintense dissemination throughout the white matter on T2WI. An initial diagnosis of possible progressive multifocal leukoencephalopathy was made, but the PCR for JC virus DNA was negative in the CSF. The leukoencephalopathy might have been caused by a mechanism related to tocilizumab itself. It is strongly recommended to perform MRI if a patient develops any cognitive impairment during tocilizumab therapy.
authors: Department of Neurology, Kyoto University Hospital, Kyoto.
authors: Katsuya
authors: K
authors: Kobayashi
authors: Yoko
authors: Y
authors: Okamoto
authors: Haruhisa
authors: H
authors: Inoue
authors: Takashi
authors: T
authors: Usui
authors: Masafumi
authors: M
authors: Ihara
authors: Jun
authors: J
authors: Kawamata
authors: Yukio
authors: Y
authors: Miki
authors: Tsuneyo
authors: T
authors: Mimori
authors: Hidekazu
authors: H
authors: Tomimoto
authors: Ryosuke
authors: R
authors: Takahashi
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D019947:Receptors, Interleukin-6 / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D019947:Receptors, Interleukin-6; C502936:tocilizumab