title: Macrophage activation syndrome with acute hepatitis E during tocilizumab treatment for rheumatoid arthritis.
abstract: Tocilizumab is a humanized antibody against the membrane and soluble receptors for interleukin-6. Tocilizumab is among the disease-modifying antirheumatic drugs (DMARDs) used to treat moderate-to-severe active rheumatoid arthritis (RA) refractory to conventional DMARDs. We report a case of macrophage activation syndrome that complicated acute hepatitis E and started within 24hours after the fourth tocilizumab infusion in a patient with RA.
authors: Service de rhumatologie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP90347, 35203 Rennes cedex 2, France.
authors: Marie
authors: M
authors: Leroy
authors: Service de rhumatologie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP90347, 35203 Rennes cedex 2, France. Electronic address: guillaume.coiffier@chu-rennes.fr.
authors: Guillaume
authors: G
authors: Coiffier
authors: Service de virologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
authors: Charlotte
authors: C
authors: Pronier
authors: Service de pharmacologie et toxicologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
authors: Louise
authors: L
authors: Triquet
authors: Service de rhumatologie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP90347, 35203 Rennes cedex 2, France.
authors: Aleth
authors: A
authors: Perdriger
authors: Service de rhumatologie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP90347, 35203 Rennes cedex 2, France.
authors: Pascal
authors: P
authors: Guggenbuhl
mesh_terms: D000208:Acute Disease; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D005260:Female; D016751:Hepatitis E / Q000150:complications*; D006801:Humans; D007262:Infusions, Intravenous; D055501:Macrophage Activation Syndrome / Q000209:etiology*; D012720:Severity of Illness Index
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C502936:tocilizumab
keywords: Acute hepatitis E; Macrophage activation syndrome; Rheumatoid arthritis; Tocilizumab