Short-term add-on tocilizumab and intravenous cyclophosphamide exhibited a remission-inducing effect in a patient with systemic lupus erythematosus with refractory multiorgan involvements including massive pericarditis and glomerulonephritis |
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| Authors: | Atsuko Iwai Shinya Tamechika Shinji Maeda |
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| Affiliation: | 1. Division of Respiratory Medicine, Allergy and Rheumatology, Nagoya City University Hospital, Nagoya, Aichi, Japan;2. Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan;3. Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya, Aichi, Japan |
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| Abstract: | We report on a 41-year-old woman with refractory systemic lupus erythematosus with massive pericarditis, macrophage activation syndrome, and glomerulonephritis despite high-dose glucocorticoids and tacrolimus. Tocilizumab dramatically improved pericarditis, and glomerulonephritis was controlled after adding cyclophosphamide. We had to halt tocilizumab and cyclophosphamide due to possible pneumocystis infection after five and three infusions of tocilizumab and intravenous cyclophosphamide, respectively. Nevertheless, no lupus flare had been observed on glucocorticoid monotherapy and enabled further rapid tapering prednisolone. |
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| Keywords: | Cyclophosphamide Pericarditis Systemic lupus erythematosus Tocilizumab |
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