title: A case of multicentric Castleman's disease having lung lesion successfully treated with humanized anti-interleukin-6 receptor antibody, tocilizumab.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, National Defense Medical College, Saitama, Japan. hiromedic@yahoo.co.jp
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Higuchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakanishi
authors.forename: Kunio
authors.initials: K
authors.lastname: Takada
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Okada
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Horikoshi
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Suzuki
mesh_terms: 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
chemical_list: 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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