title: Successful treatment of a patient with rheumatoid arthritis and IgA-κ multiple myeloma with tocilizumab.
abstract: A 63-year-old woman receiving tumor necrosis factor (TNF) inhibitors for rheumatoid arthritis (RA) was found to have smoldering IgA-kappa type multiple myeloma (MM). Retrospective examination of stored serum samples revealed a steady increase of serum IgA levels after the start of TNF inhibitor therapy. The patient's articular symptoms showed marked exacerbation when TNF inhibitors were discontinued because of fear of worsening the MM. Tocilizumab improved RA symptoms dramatically and stabilized serum IgA levels for 13 months after a transient steep rise. This case suggests that tocilizumab can be used safely in patients with inflammatory disorders with coexisting MM.
authors.affiliation: Division of Rheumatology and Clinical Immunology, Jichi Medical University, Japan. yasushim@jichi.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsuyama
authors.forename: Takao
authors.initials: T
authors.lastname: Nagashima
authors.forename: Kyoko
authors.initials: K
authors.lastname: Honne
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kamata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Iwamoto
authors.forename: Hitoaki
authors.initials: H
authors.lastname: Okazaki
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sato
authors.forename: Keiya
authors.initials: K
authors.lastname: Ozawa
authors.forename: Seiji
authors.initials: S
authors.lastname: Minota
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007145:Immunoglobulin kappa-Chains / Q000096:biosynthesis*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D010951:Plasma Exchange / Q000379:methods; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D007070:Immunoglobulin A; D007145:Immunoglobulin kappa-Chains; C502936:tocilizumab