Therapeutic Benefits of Tocilizumab Vary in Different Organs of a Patient with AA Amyloidosis
نویسندگان
چکیده
Systemic reactive AA amyloidosis is a life-threatening complication of chronic inflammatory diseases. Anti-interleukin-6 receptor, tocilizumab (TCZ), has been shown to improve clinical symptoms of patients with AA amyloidosis, accompanied with regression of the amyloid deposition. We report a case of AA amyloidosis evaluated by histology of multiple organs before and after TCZ treatment. A woman in her 60s with rheumatoid arthritis was referred to our hospital because of cardiac and renal dysfunction. A gastric and renal biopsy revealed the deposition of AA amyloid, and echocardiography revealed concentric left ventricular hypertrophy. Her estimated glomerular filtration rate was decreased to 8.6 mL/min/1.73 m(2), and B-type natriuretic peptide, C-reactive protein, and serum amyloid A protein were significantly elevated. TCZ treatments markedly decreased her serum amyloid A protein and C-reactive protein levels, but hemodialysis was required 1 year later. Endoscopic gastric rebiopsy 3 years after initiation of TCZ treatments revealed the regression of amyloid deposition and echocardiography revealed improvement of her left ventricular hypertrophy. However, a renal rebiopsy revealed that the amyloid deposition had not regressed. In conclusion, these observations suggest that the therapeutic effects of TCZ can vary among organs in patients with AA amyloidosis.
منابع مشابه
OR14-001 – Tocilizumab in autoinflammation and AA amyloidosis
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Objectives: Several biologics therapy reportedly regress gastric amyloid deposition in AA amyloidosis patients, but it is uncertain whether they can also regress renal amyloid deposition. We carried out serial renal biopsy to clarify the regression of amyloid deposition in kidney by biologics. Methods: After the diagnosis of AA amyloidosis was determined by gastric biopsy to rheumatoid arthriti...
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ورودعنوان ژورنال:
دوره 2014 شماره
صفحات -
تاریخ انتشار 2014