Harada Masaru, Honma Yuichi, Shiba Eisuke, Tomosugi Naohisa, Harada Riko
Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan.
Department of Pathology and Oncology, University of Occupational and Environmental Health, Japan.
Intern Med. 2025 May 1;64(9):1334-1337. doi: 10.2169/internalmedicine.4329-24. Epub 2024 Oct 11.
A 75-year-old woman visited to our hospital with liver dysfunction. The patient's liver function was normal. She had been treated with tocilizumab for rheumatoid arthritis for two years. One year after initiation of tocilizumab treatment, liver dysfunction was observed. Serum ceruloplasmin concentration was low. We diagnosed hepatic iron overload because of a high ferritin concentration and a liver biopsy. The cessation of tocilizumab and phlebotomy improved the liver function. We believe that tocilizumab induced iron accumulation. We should be aware of the possibility that tocilizumab induces iron overload in susceptible patients and monitor iron status in patients treated with tocilizumab.
一名75岁女性因肝功能不全前来我院就诊。患者肝功能此前正常。她接受托珠单抗治疗类风湿关节炎已两年。在托珠单抗治疗开始一年后，观察到肝功能不全。血清铜蓝蛋白浓度较低。由于铁蛋白浓度升高及肝脏活检，我们诊断为肝铁过载。停用托珠单抗并进行放血治疗后肝功能得到改善。我们认为托珠单抗诱导了铁蓄积。我们应意识到托珠单抗可能在易感患者中诱导铁过载，并应对接受托珠单抗治疗的患者监测铁状态。
