title: Refractory neuro-Behçet treated by tocilizumab: a case report.
abstract: A patient with central nervous system involvement of Behçet's disease was refractory to conventional immunosuppressive therapy and showed secondary failure of the anti-TNF agent infliximab. This presented as a progressive weakness of the legs and reduction in walking distance. The cerebrospinal fluid showed signs of inflammation including a vastly elevated IL-6 concentration. Given this result, the anti-IL-6 receptor antibody tocilizumab was administered and a good improvement of inflammatory parameters and a satisfactory increase of the walking distance were achieved.
authors.affiliation: Rheumaklinik und Institut für Physikalische Medizin und Rehabilitation, Kantonsspital Aarau AG, CH-5001Aarau, Switzerland. piotr.urbaniak@usz.ch
authors.forename: P
authors.initials: P
authors.lastname: Urbaniak
authors.forename: P
authors.initials: P
authors.lastname: Hasler
authors.forename: S
authors.initials: S
authors.lastname: Kretzschmar
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001528:Behcet Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000134:cerebrospinal fluid; D000069285:Infliximab; D015850:Interleukin-6 / Q000134:cerebrospinal fluid; D035002:Lower Extremity / Q000294:innervation*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019947:Receptors, Interleukin-6 / Q000037:antagonists & inhibitors / Q000378:metabolism; D020127:Recovery of Function; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D016138:Walking
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C508600:IL6 protein, human; D007166:Immunosuppressive Agents; D018836:Inflammation Mediators; D015850:Interleukin-6; D019947:Receptors, Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; C502936:tocilizumab