Efficacy of tocilizumab for psychiatric symptoms associated with relapsing polychondritis: the first case report and review of the literature.
Relapsing polychondritis (RP) rarely affected the central nervous system (CNS). If the CNS is involved, it can result in psychiatric manifestations. Patients with RP always respond well to glucocorticoids and immunosuppressants. If the therapies fail, biologics can be given, such as tocilizumab, which is a humanized monoclonal antibody against the interleukin-6 receptor (IL-6R). Until now, there have been no randomized clinical trials to test the safety and efficacy of biologics, no reports of RP with psychiatric disorders as initial symptoms, and no reports of tocilizumab used for psychiatric symptoms due to RP. Here, we report a 60-year-old woman with mania, logomania, hallucinations, cognitive disorder, persecutory delusion, and violent tendency as chief complaints. The application of dexamethasone worsened her psychiatric symptoms. After the first infusion of tocilizumab, she achieved complete remission within one week. During the follow-up period, she sustained serological and psychiatric remission. Our case illustrates the safety and efficacy of tocilizumab for psychiatric symptoms of RP.
Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshedong Road, Erqi District, Zhengzhou, Henan, China.
Lijun
L
Liu
Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshedong Road, Erqi District, Zhengzhou, Henan, China. shengyun19690505@163.com.
Shengyun
S
Liu
Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshedong Road, Erqi District, Zhengzhou, Henan, China.
Wenjuan
W
Guan
Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshedong Road, Erqi District, Zhengzhou, Henan, China.
Lei
L
Zhang
D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000209:etiology; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006212:Hallucinations / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D011081:Polychondritis, Relapsing / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; C502936:tocilizumab
Glucocorticoid; Psychiatric symptoms; Relapsing polychondritis; Tocilizumab