title: A fatal case of acute exacerbation of interstitial lung disease in a patient with rheumatoid arthritis during treatment with tocilizumab.
abstract: A 68-year-old man, who was a patient with established rheumatoid arthritis (RA) with RA-associated interstitial lung disease (RA-ILD) and pulmonary emphysema, began taking tocilizumab. Subsequently, he developed dyspnea parallel to improvement of RA. At 10 months after the administration of tocilizumab, he was urgently admitted because of exacerbation of ILD. He died despite receiving steroid pulse therapy and antibiotic therapy on a respirator. This is the first case report to describe the exacerbation of ILD during treatment with tocilizumab in the postmarketing surveillance (PMS) period.
authors.affiliation: Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. shinya22@nagasaki-u.ac.jp
authors.forename: Shin-Ya
authors.initials: SY
authors.lastname: Kawashiri
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
authors.forename: Noriho
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ishimatsu
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D017809:Fatal Outcome; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000209:etiology*; D008297:Male
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; C502936:tocilizumab