A case of rheumatoid arthritis and limited systemic sclerosis overlap successfully treated with tocilizumab for arthritis and concomitant generalized lymphadenopathy and primary biliary cirrhosis.
A 57-year-old woman with rheumatoid arthritis (RA) and limited systemic sclerosis (lSSc) was suspected to have lymphadenopathy and primary biliary cirrhosis (PBC). Lymph node biopsy showed reactive follicular lymphadenopathy with intrafollicular plasmacyte infiltration that was interleukin-6 positive by immunohistostaining. Because of gradually worsening arthritis, tocilizumab was administered and arthritis improved markedly. Interestingly, lymphadenopathy and PBC improved simultaneously. This suggested that interleukin-6 might play an important role in reactive lymphadenopathy and PBC associated with RA/lSSc.
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Eiko
E
Saito
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Shinji
S
Sato
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Shinichi
S
Nogi
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Noriko
N
Sasaki
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Naofumi
N
Chinen
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Kiri
K
Honda
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Takayuki
T
Wakabayashi
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Chiho
C
Yamada
Department of Pathology, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Naoya
N
Nakamura
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, 142 Shimokasuya, Isehara 160-8582, Japan.
Yasuo
Y
Suzuki