Acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis

Tomohito Sato,1 Shinya Minakuchi,1 Manabu Mochizuki,2 Masaru Takeuchi11Department of Ophthalmology, National Defense Medical College, Saitama, Japan; 2Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, JapanBackground: Tocilizumab...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sato T, Minakuchi S, Mochizuki M, Takeuchi M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/d1322a73aef748eb90dc3e85cb6e59dc
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:d1322a73aef748eb90dc3e85cb6e59dc
record_format	dspace
spelling	oai:doaj.org-article:d1322a73aef748eb90dc3e85cb6e59dc2021-12-02T05:00:37ZAcute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis1177-5483https://doaj.org/article/d1322a73aef748eb90dc3e85cb6e59dc2014-01-01T00:00:00Zhttp://www.dovepress.com/acute-anterior-uveitis-after-discontinuation-of-tocilizumab-in-a-patie-a15443https://doaj.org/toc/1177-5483 Tomohito Sato,1 Shinya Minakuchi,1 Manabu Mochizuki,2 Masaru Takeuchi11Department of Ophthalmology, National Defense Medical College, Saitama, Japan; 2Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, JapanBackground: Tocilizumab is a humanized monoclonal anti-interleukin-6 (IL-6) receptor antibody and has been approved in Japan for the treatment of Castleman's disease, rheumatoid arthritis (RA), and systemic juvenile idiopathic arthritis. Conjunctivitis and dry eye are known ocular adverse effects, but uveitis has not been reported.Case report: A 72-year-old woman had undergone bilateral cataract surgery without complications. Six months after the surgery, she was diagnosed with RA and treated with tocilizumab infusion every 4 weeks. However, severe malaise and dizziness occurred after the third tocilizumab infusion, and the treatment was suspended. Since the symptoms associated with RA had resolved, she was followed without any medication thereafter. At 5 weeks after the third tocilizumab infusion, she developed severe anterior inflammation with hypopyon in her left eye, and her visual acuity dropped to less than 2/200. Considering her age and history of cataract surgery, endophthalmitis was suspected and a vitrectomy was performed, but no pathogens were detected from the intraocular fluid samples collected during surgery. The ocular inflammation was gradually resolved with systemic antibiotics and corticosteroids. However, severe anterior uveitis recurred in the same eye during the tapering of the systemic corticosteroids, when the aqueous humor IL-6 level was 46,100 pg/mL. The recurrent ocular inflammation was resolved with increased doses of topical and systemic corticosteroids, and the patient has since remained relapse-free. No symptom of inflammation was observed in the right eye during the follow-up period.Conclusion: This case indicates a possibility that acute anterior uveitis may have been an adverse effect after the discontinuation of anti-IL-6 receptor antibody therapy in a patient with RA.Keyword: interleukin-6Sato TMinakuchi SMochizuki MTakeuchi MDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 187-190 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Sato T Minakuchi S Mochizuki M Takeuchi M Acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis
description	Tomohito Sato,1 Shinya Minakuchi,1 Manabu Mochizuki,2 Masaru Takeuchi11Department of Ophthalmology, National Defense Medical College, Saitama, Japan; 2Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, JapanBackground: Tocilizumab is a humanized monoclonal anti-interleukin-6 (IL-6) receptor antibody and has been approved in Japan for the treatment of Castleman's disease, rheumatoid arthritis (RA), and systemic juvenile idiopathic arthritis. Conjunctivitis and dry eye are known ocular adverse effects, but uveitis has not been reported.Case report: A 72-year-old woman had undergone bilateral cataract surgery without complications. Six months after the surgery, she was diagnosed with RA and treated with tocilizumab infusion every 4 weeks. However, severe malaise and dizziness occurred after the third tocilizumab infusion, and the treatment was suspended. Since the symptoms associated with RA had resolved, she was followed without any medication thereafter. At 5 weeks after the third tocilizumab infusion, she developed severe anterior inflammation with hypopyon in her left eye, and her visual acuity dropped to less than 2/200. Considering her age and history of cataract surgery, endophthalmitis was suspected and a vitrectomy was performed, but no pathogens were detected from the intraocular fluid samples collected during surgery. The ocular inflammation was gradually resolved with systemic antibiotics and corticosteroids. However, severe anterior uveitis recurred in the same eye during the tapering of the systemic corticosteroids, when the aqueous humor IL-6 level was 46,100 pg/mL. The recurrent ocular inflammation was resolved with increased doses of topical and systemic corticosteroids, and the patient has since remained relapse-free. No symptom of inflammation was observed in the right eye during the follow-up period.Conclusion: This case indicates a possibility that acute anterior uveitis may have been an adverse effect after the discontinuation of anti-IL-6 receptor antibody therapy in a patient with RA.Keyword: interleukin-6
format	article
author	Sato T Minakuchi S Mochizuki M Takeuchi M
author_facet	Sato T Minakuchi S Mochizuki M Takeuchi M
author_sort	Sato T
title	Acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis
title_short	Acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis
title_full	Acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis
title_fullStr	Acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis
title_full_unstemmed	Acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis
title_sort	acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/d1322a73aef748eb90dc3e85cb6e59dc
work_keys_str_mv	AT satot acuteanterioruveitisafterdiscontinuationoftocilizumabinapatientwithrheumatoidarthritis AT minakuchis acuteanterioruveitisafterdiscontinuationoftocilizumabinapatientwithrheumatoidarthritis AT mochizukim acuteanterioruveitisafterdiscontinuationoftocilizumabinapatientwithrheumatoidarthritis AT takeuchim acuteanterioruveitisafterdiscontinuationoftocilizumabinapatientwithrheumatoidarthritis
_version_	1718400856268734464

Acute anterior uveitis after discontinuation of tocilizumab in a patient with rheumatoid arthritis

Ejemplares similares