A case of multicentric Castleman's disease having lung lesion successfully treated with humanized anti-interleukin-6 receptor antibody, tocilizumab.
This report presents the case of a patient demonstrating multicentric Castleman's disease (MCD) with a lung lesion that was successfully treated with an anti-interleukin-6 receptor antibody, tocilizumab in combination with corticosteroid and tacrolimus. A 43-yr-old female with abnormal shadows on a chest X-ray was referred to the hospital for further examination. She was diagnosed as having MCD based on the characteristic pathology of inguinal lymph node, lung lesions, laboratory data, and undifferentiated arthritis. Corticosteroid and rituximab therapy did not fully ameliorate the symptoms; thus, the therapeutic regimen was changed to include tocilizumab, oral corticosteroid and tacrolimus. This regimen resulted in clinical remission and the dose of tocilizumab and corticosteroid could be tapered. Tocilizumab in combination with corticosteroid and tacrolimus may therefore be a beneficial treatment regimen for lung lesions associated with MCD.
Higuchi
Tomoaki
T
Department of Internal Medicine, Division of Rheumatology, National Defense Medical College, Saitama, Japan. hiromedic@yahoo.co.jp
Nakanishi
Takashi
T
Takada
Kunio
K
Matsumoto
Mitsuyo
M
Okada
Makoto
M
Horikoshi
Hideyuki
H
Suzuki
Kimihiro
K
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D005871:Castleman Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017563:Lung Diseases, Interstitial / Q000188:drug therapy* / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D019947:Receptors, Interleukin-6 / Q000037:antagonists & inhibitors; D016559:Tacrolimus / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D019947:Receptors, Interleukin-6; C502936:tocilizumab; D016559:Tacrolimus
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