Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan.
Department of Rheumatology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan.
Intern Med. 2022 Apr 1;61(7):1011-1014. doi: 10.2169/internalmedicine.8031-21. Epub 2021 Sep 18.
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.
托珠单抗（TCZ）引起的肠道黏膜损伤是一种并发症，通常与憩室病有关。我们在此报告一例罕见的 TCZ 诱导的肠道黏膜损伤病例，该患者无憩室病。一名 74 岁女性患有类风湿关节炎，开始接受 TCZ 治疗。6 个月后，她出现血便和腹痛。结肠镜检查显示从盲肠到横结肠有多个溃疡，但没有憩室病。停用 TCZ 三个月后，这些病变得到治愈。我们应将 TCZ 视为肠道黏膜损伤的一个危险因素，即使患者没有与憩室病相关的肠道疾病史。
