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A Rare Case of Rheumatoid Arthritis with Tocilizumab-induced Intestinal Mucosal Injury
Authors:Akito Ohkubo  Takashi Osoegawa  Naohiko Harada  Yoichiro Iboshi  Yorinobu Sumida  Makoto Nakamuta  Eiichi Suematsu  Hiroyuki Kobayashi  Eikichi Ihara
Affiliation:1.Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan; 2.Department of Rheumatology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan; 3.Department of Gastroenterology, Fukuoka Sanno Hospital, Japan; 4.Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Japan
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. We should consider TCZ as a risk factor for intestinal mucosal injury, even if patients have no history of intestinal disease associated with diverticulosis.
Keywords:tocilizumab   IL-6   enteritis   rheumatoid arthritis
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