[Long-term treatment with a humanized anti-interleukin-6 receptor antibody (tocilizumab), improving interstitial pneumonia in a patient with multicentric Castleman disease].
A 46-year-old man was admitted for the evaluation of a dry cough and dyspnea on exertion. Laboratory tests revealed anemia, elevated CRP, polyclonal hyperimmunoglobulinemia, and an elevated interleukin-6 level. Radiological examination of the chest showed peribronchovascular consolidations, ground glass opacities, small nodular opacities, and interlobular septal thickenings in the lungs, accompanied with hilar and mediastinal lymphadenopathies. A video-assisted thoracoscopic lung and mediastinal lymph node biopsy revealed plasmacytic and lymphocytic infiltration around the bronchovascular bundles of the lungs, and plasmacytic infiltration in the interfollicular areas of the nodes. Based on these findings, a diagnosis of multicentric Castleman disease was confirmed. The patient received a humanized anti-interleukin-6 receptor antibody, (tocilizumab, 8 mg/kg), every 2 weeks for 3 years, during which time, his PaO2 level improved from 64.1 Torr to 83.4 Torr, vital capacity increased from 2.53 L to 3.95 L, and radiological abnormalities in the lungs gradually improved, suggesting that tocilizumab is effective for interstitial pneumonia in patients with multicentric Castleman disease.
Harada
Naoko
N
Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, Keio University.
Sayama
Koichi
K
Tanaka
Kyuto
K
Hasegawa
Naoki
N
Okamoto
Shinichiro
S
Hayashi
Yuichiro
Y
Ishizaka
Akitoshi
A
D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D005871:Castleman Disease / Q000150:complications*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C502936:tocilizumab