title: Primary varicella infection in children with systemic juvenile idiopathic arthritis under tocilizumab therapy.
abstract: We report the clinical course and outcome of primary varicella infection in six children with systemic juvenile idiopathic arthritis (sJIA) receiving tocilizumab. None had disseminated or fatal varicella infection, but one patient developed macrophage activation syndrome (MAS) and another had an arthritis relapse. All patients had a significant elevation of serum IL-6 levels, and the two children who developed MAS or arthritis relapse showed high serum IL-18 levels, which could cause a sJIA flare-up.
authors.affiliation: a Department of Pediatrics , Yokohama City University Graduate School of Medicine , Yokohama City , Japan.
authors.forename: Tomo
authors.initials: T
authors.lastname: Nozawa
authors.affiliation: a Department of Pediatrics , Yokohama City University Graduate School of Medicine , Yokohama City , Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: a Department of Pediatrics , Yokohama City University Graduate School of Medicine , Yokohama City , Japan.
authors.forename: Asami
authors.initials: A
authors.lastname: Ohara
authors.affiliation: a Department of Pediatrics , Yokohama City University Graduate School of Medicine , Yokohama City , Japan.
authors.forename: Ryoki
authors.initials: R
authors.lastname: Hara
authors.affiliation: a Department of Pediatrics , Yokohama City University Graduate School of Medicine , Yokohama City , Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ito
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000150:complications* / Q000188:drug therapy; D002644:Chickenpox / Q000097:blood / Q000209:etiology / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D020382:Interleukin-18 / Q000097:blood; D055501:Macrophage Activation Syndrome / Q000097:blood / Q000209:etiology / Q000473:pathology*; D008297:Male
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C000589760:IL18 protein, human; D007166:Immunosuppressive Agents; D020382:Interleukin-18; C502936:tocilizumab
keywords: IL-6; Macrophage activation syndrome; Systemic juvenile idiopathic arthritis; Tocilizumab; Varicella