title: [A case of gastrointestinal amyloidosis and hypoproteinemia improved by tocilizumab].
abstract: A woman in her 70s presented with dehydration and malnutrition due to watery diarrhea. She was examined and diagnosed with gastrointestinal amyloidosis accompanied by a protein-losing gastroenteropathy secondary to rheumatoid arthritis. She first underwent treatment with an anti-tumor necrosis factor alpha (TNF-α) antibody for secondary amyloidosis, but due to lack of adequate response, she was switched to an anti-interleukin (IL)-6 receptor antibody. Her clinical symptoms subsequently improved, and endoscopy revealed a marked decrease of amyloid protein deposits in the digestive tract. She was followed up for 3 years while continuing to receive the anti-IL-6 receptor antibody, with no recurrence. Although secondary amyloidosis is a fatal disease associated with chronic inflammatory diseases, clinical symptoms and prognosis have recently been improved by intervention with biological therapies. In particular, anti-IL-6 receptor antibodies have been reported to be superior to anti-TNF-α antibodies in the treatment of secondary amyloidosis and are expected to play a central role in treating secondary amyloidosis in the future.
authors: Department of Gastroenterology, Matsushita Memorial Hospital.
authors: Katsuyuki
authors: K
authors: Dainaka
authors: Yutaka
authors: Y
authors: Isozaki
authors: Keisuke
authors: K
authors: Kunieda
authors: Shun
authors: S
authors: Takayama
authors: Rieko
authors: R
authors: Mukai
authors: Nobuhisa
authors: N
authors: Yamada
authors: Yasutaka
authors: Y
authors: Morimoto
authors: Yasutaka
authors: Y
authors: Nagao
authors: Hirokazu
authors: H
authors: Oyamada
authors: Kenji
authors: K
authors: Kawabata
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications; D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007019:Hypoproteinemia / Q000209:etiology; D015850:Interleukin-6 / Q000276:immunology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C508600:IL6 protein, human; D015850:Interleukin-6; C502936:tocilizumab