University Department of Rheumatology, Physical and Rehabilitation Medicine, School of Medicine Zagreb, University Hospital Centre Sestre Milosrdnice, Vinogradska 29, 10000, Zagreb, Croatia.
University Department of Urology, University Hospital Centre Sestre Milosrdnice, Vinogradska 29, 10000, Zagreb, Croatia.
Rheumatol Int. 2021 Apr;41(4):819-825. doi: 10.1007/s00296-021-04800-y. Epub 2021 Feb 12.
Interleukin-6 receptor antagonist tocilizumab is a biologic drug used for treating patients with active rheumatoid arthritis (RA) who failed to respond to synthetic or other biologic disease-modifying antirheumatic drugs or where they were contraindicated. Interleukin-6 receptor blockade results in a decrease of disease activity but has some potential adverse effects, the most common being infections. We present a case of a 75-year-old female patient with long-lasting RA, several comorbidities and multiple prior therapies, who developed back pain and general malaise during tocilizumab intravenous treatment. The laboratory findings were typical of toxemia, and the imaging findings revealed large psoas muscle abscess. Surgical and antibiotic treatment was performed with a good outcome. To our knowledge, this has been the first case of a psoas abscess in a patient with RA treated with tocilizumab described in the literature so far. We also present a review of the literature regarding infection, and particularly abscess formation in patients treated with biological disease-modifying antirheumatic drugs, tocilizumab included.
白细胞介素-6 受体拮抗剂托珠单抗是一种生物制剂，用于治疗对合成或其他生物疾病修正抗风湿药物反应不佳或有禁忌的活动性类风湿关节炎 (RA) 患者。白细胞介素-6 受体阻断导致疾病活动减少，但有一些潜在的不良反应，最常见的是感染。我们报告了一例 75 岁女性患者，患有长期 RA、多种合并症和多种既往治疗，在托珠单抗静脉治疗期间出现背痛和全身不适。实验室发现符合中毒表现，影像学发现巨大腰大肌脓肿。采用手术和抗生素治疗，结果良好。据我们所知，这是迄今为止文献中首例 RA 患者在接受托珠单抗治疗时发生腰大肌脓肿的病例。我们还回顾了文献中关于感染，特别是包括托珠单抗在内的生物疾病修正抗风湿药物治疗患者脓肿形成的相关内容。
