Interstitial lung disease occurring shortly after tocilizumab infusion in a patient with polyarticular juvenile idiopathic arthritis: a case report

Abstract

Background Tocilizumab has been shown to be effective for treatment of juvenile idiopathic arthritis (JIA). To our knowledge, this is the first reported case of interstitial lung disease occurring shortly after tocilizumab infusion in a patient with JIA. Case presentation A 14-year-old female patient with polyarticular JIA developed interstitial lung disease after intravenous and subcutaneous administration of tocilizumab. Her condition improved with glucocorticoid therapy. Conclusion Our results suggest that increased interleukin-6 levels in the blood following tocilizumab treatment may be linked to development of interstitial lung disease.

Immune-related adverse events of biological immunotherapies used in COVID-19

“…Drug-induced interstitial lung disease (DILD) is an infrequent adverse effect caused by tocilizumab; nevertheless, there have been post-marketing reports in large retrospective cohort studies (Curtis et al, 2015) and RCTs (Smolen et al, 2008;Fact Sheet For Healthcare Providers, 2021). The principally reported DILDs are acute pneumonitis, idiopathic pulmonary fibrosis, and exacerbation of rheumatoid arthritis-associated interstitial lung disease (Kawashiri et al, 2012;Sangüesa Gómez et al, 2016;Gouveia et al, 2020;Silva et al, 2020;Sugihara et al, 2021). The mechanism whereby tocilizumab induces interstitial lung disease is unknown; however, two mechanisms for DILD are commonly described.…”