A Rare Case of Rheumatoid Arthritis with Tocilizumab-induced Intestinal Mucosal Injury
Intestinal mucosal injury that develops as a complication of tocilizumab (TCZ) is usually associated with diverticulosis. We herein report a rare case of TCZ-induced intestinal mucosal injury in the absence of diverticulosis. A 74-year-old woman suffering from rheumatoid arthritis started taking TCZ...
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| Veröffentlicht in: | Internal Medicine 2022/04/01, Vol.61(7), pp.1011-1014 |
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| creator | Ohkubo, Akito Osoegawa, Takashi Harada, Naohiko Iboshi, Yoichiro Sumida, Yorinobu Nakamuta, Makoto Suematsu, Eiichi Kobayashi, Hiroyuki Ihara, Eikichi |
| description | Intestinal mucosal injury that develops as a complication of tocilizumab (TCZ) is usually associated with diverticulosis. We herein report a rare case of TCZ-induced intestinal mucosal injury in the absence of diverticulosis. A 74-year-old woman suffering from rheumatoid arthritis started taking TCZ. Six months later, she complained of hematochezia and abdominal pain. Colonoscopy revealed multiple ulcers spreading from the cecum to the transverse colon but no diverticulosis. These lesions were cured at three months after the discontinuation of TCZ. We should consider TCZ as a risk factor for intestinal mucosal injury, even if patients have no history of intestinal disease associated with diverticulosis. |
| doi_str_mv | 10.2169/internalmedicine.8031-21 |
| format | Article |
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We herein report a rare case of TCZ-induced intestinal mucosal injury in the absence of diverticulosis. A 74-year-old woman suffering from rheumatoid arthritis started taking TCZ. Six months later, she complained of hematochezia and abdominal pain. Colonoscopy revealed multiple ulcers spreading from the cecum to the transverse colon but no diverticulosis. These lesions were cured at three months after the discontinuation of TCZ. We should consider TCZ as a risk factor for intestinal mucosal injury, even if patients have no history of intestinal disease associated with diverticulosis.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.8031-21</identifier><identifier>PMID: 34544951</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Aged ; Antibodies, Monoclonal, Humanized - adverse effects ; Antirheumatic Agents - adverse effects ; Arthritis, Rheumatoid - complications ; Arthritis, Rheumatoid - drug therapy ; Case Report ; Cecum ; Colon ; enteritis ; Female ; Humans ; IL-6 ; Internal medicine ; Intestine ; Mucosa ; Rheumatoid arthritis ; Risk factors ; tocilizumab ; Treatment Outcome ; Ulcers</subject><ispartof>Internal Medicine, 2022/04/01, Vol.61(7), pp.1011-1014</ispartof><rights>2022 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2022</rights><rights>Copyright © 2022 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c609t-9dc1fdadb535c44bcdbcf4e7e21f782b0808718abd09fa69e4d3f02870ab96073</citedby><cites>FETCH-LOGICAL-c609t-9dc1fdadb535c44bcdbcf4e7e21f782b0808718abd09fa69e4d3f02870ab96073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9038478/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9038478/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,1877,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34544951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ohkubo, Akito</creatorcontrib><creatorcontrib>Osoegawa, Takashi</creatorcontrib><creatorcontrib>Harada, Naohiko</creatorcontrib><creatorcontrib>Iboshi, Yoichiro</creatorcontrib><creatorcontrib>Sumida, Yorinobu</creatorcontrib><creatorcontrib>Nakamuta, Makoto</creatorcontrib><creatorcontrib>Suematsu, Eiichi</creatorcontrib><creatorcontrib>Kobayashi, Hiroyuki</creatorcontrib><creatorcontrib>Ihara, Eikichi</creatorcontrib><title>A Rare Case of Rheumatoid Arthritis with Tocilizumab-induced Intestinal Mucosal Injury</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>Intestinal mucosal injury that develops as a complication of tocilizumab (TCZ) is usually associated with diverticulosis. We herein report a rare case of TCZ-induced intestinal mucosal injury in the absence of diverticulosis. A 74-year-old woman suffering from rheumatoid arthritis started taking TCZ. Six months later, she complained of hematochezia and abdominal pain. Colonoscopy revealed multiple ulcers spreading from the cecum to the transverse colon but no diverticulosis. These lesions were cured at three months after the discontinuation of TCZ. We should consider TCZ as a risk factor for intestinal mucosal injury, even if patients have no history of intestinal disease associated with diverticulosis.</description><subject>Aged</subject><subject>Antibodies, Monoclonal, Humanized - adverse effects</subject><subject>Antirheumatic Agents - adverse effects</subject><subject>Arthritis, Rheumatoid - complications</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Case Report</subject><subject>Cecum</subject><subject>Colon</subject><subject>enteritis</subject><subject>Female</subject><subject>Humans</subject><subject>IL-6</subject><subject>Internal medicine</subject><subject>Intestine</subject><subject>Mucosa</subject><subject>Rheumatoid arthritis</subject><subject>Risk factors</subject><subject>tocilizumab</subject><subject>Treatment Outcome</subject><subject>Ulcers</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkU1v1DAQhi0EokvhLyBLXLik-DO2L0irFdCVCkhV4Wo5ttN4lY2L7YDKr6-jXVZQLjOHeeadjxcAiNEFwa16F6bi02TGvXfBhslfSERxQ_ATsMKUqUYQyp-CFVJYNqSGM_Ai5x1CVApFnoMzyjhjiuMV-L6G1yZ5uDHZw9jD68HPe1NicHCdypBCCRn-CmWAN9GGMfyu1a4Jk5utd3Bb98gl1E3g59nGXPN22s3p_iV41psx-1fHfA6-ffxws7lsrr5-2m7WV41tkSqNchb3zriOU24Z66zrbM-88AT3QpIOSSQFlqZzSPWmVZ452iMiBTKdapGg5-D9Qfdu7uozrJ9KMqO-S2Fv0r2OJuh_K1MY9G38qVX9BROyCrw9CqT4Y67H6H3I1o-jmXycsyZccNQqrlhF3zxCd3FeXKhUy1rMOSOLoDxQNsWck-9Py2CkF_P0Y_P0Yl4t1dbXfx9zavzjVgW-HIBdLubWnwCTSrCj_1-5xVos4TjhBNrBJO0n-gAwR7nZ</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Ohkubo, Akito</creator><creator>Osoegawa, Takashi</creator><creator>Harada, Naohiko</creator><creator>Iboshi, Yoichiro</creator><creator>Sumida, Yorinobu</creator><creator>Nakamuta, Makoto</creator><creator>Suematsu, Eiichi</creator><creator>Kobayashi, Hiroyuki</creator><creator>Ihara, Eikichi</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220401</creationdate><title>A Rare Case of Rheumatoid Arthritis with Tocilizumab-induced Intestinal Mucosal Injury</title><author>Ohkubo, Akito ; Osoegawa, Takashi ; Harada, Naohiko ; Iboshi, Yoichiro ; Sumida, Yorinobu ; Nakamuta, Makoto ; Suematsu, Eiichi ; Kobayashi, Hiroyuki ; Ihara, Eikichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c609t-9dc1fdadb535c44bcdbcf4e7e21f782b0808718abd09fa69e4d3f02870ab96073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Antibodies, Monoclonal, Humanized - adverse effects</topic><topic>Antirheumatic Agents - adverse effects</topic><topic>Arthritis, Rheumatoid - complications</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Case Report</topic><topic>Cecum</topic><topic>Colon</topic><topic>enteritis</topic><topic>Female</topic><topic>Humans</topic><topic>IL-6</topic><topic>Internal medicine</topic><topic>Intestine</topic><topic>Mucosa</topic><topic>Rheumatoid arthritis</topic><topic>Risk factors</topic><topic>tocilizumab</topic><topic>Treatment Outcome</topic><topic>Ulcers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ohkubo, Akito</creatorcontrib><creatorcontrib>Osoegawa, Takashi</creatorcontrib><creatorcontrib>Harada, Naohiko</creatorcontrib><creatorcontrib>Iboshi, Yoichiro</creatorcontrib><creatorcontrib>Sumida, Yorinobu</creatorcontrib><creatorcontrib>Nakamuta, Makoto</creatorcontrib><creatorcontrib>Suematsu, Eiichi</creatorcontrib><creatorcontrib>Kobayashi, Hiroyuki</creatorcontrib><creatorcontrib>Ihara, Eikichi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ohkubo, Akito</au><au>Osoegawa, Takashi</au><au>Harada, Naohiko</au><au>Iboshi, Yoichiro</au><au>Sumida, Yorinobu</au><au>Nakamuta, Makoto</au><au>Suematsu, Eiichi</au><au>Kobayashi, Hiroyuki</au><au>Ihara, Eikichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Rare Case of Rheumatoid Arthritis with Tocilizumab-induced Intestinal Mucosal Injury</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>61</volume><issue>7</issue><spage>1011</spage><epage>1014</epage><pages>1011-1014</pages><artnum>8031-21</artnum><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>Intestinal mucosal injury that develops as a complication of tocilizumab (TCZ) is usually associated with diverticulosis. We herein report a rare case of TCZ-induced intestinal mucosal injury in the absence of diverticulosis. A 74-year-old woman suffering from rheumatoid arthritis started taking TCZ. Six months later, she complained of hematochezia and abdominal pain. Colonoscopy revealed multiple ulcers spreading from the cecum to the transverse colon but no diverticulosis. These lesions were cured at three months after the discontinuation of TCZ. 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| subjects | Aged Antibodies, Monoclonal, Humanized - adverse effects Antirheumatic Agents - adverse effects Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - drug therapy Case Report Cecum Colon enteritis Female Humans IL-6 Internal medicine Intestine Mucosa Rheumatoid arthritis Risk factors tocilizumab Treatment Outcome Ulcers |
| title | A Rare Case of Rheumatoid Arthritis with Tocilizumab-induced Intestinal Mucosal Injury |
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