Successful Treatment with Tocilizumab in a Case of Intralymphatic Histiocytosis Associated with Rheumatoid Arthritis

Nakajima, Toshiki; Kawabata, Daisuke; Nakabo, Shuichiro; Miyagawa‐Hayashino, Aya; Yukawa, Naoichiro; Yoshifuji, Hajime; Ohmura, Koichiro; Fujii, Tomoyuki; Mimori, Tsuneyo

doi:10.2169/internalmedicine.53.2688

Cited by 11 publications

(3 citation statements)

References 9 publications

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“…Currently, commonly used biological agents for RA in clinical settings include tumor necrosis factor (TNF)-α inhibitor (etanercept and infliximab) and recombinant humanized IL-6 receptor monoclonal antibody TCZ) (ACTEMRA) [ 19 , 20 ]. TNF-α inhibitor was explored early-on and its mechanism is relatively clear.…”

Section: Discussionmentioning

confidence: 99%

Interleukin-6 (IL-6) Receptor Antagonist Protects Against Rheumatoid Arthritis

et al. 2016

Med Sci Monit

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BackgroundThe aim of this study was to investigate the protective effect of interleukin-6 (IL-6) receptor antagonist tocilizumab (TCZ) on rheumatoid arthritis (RA) and its related mechanism.Material/MethodsThirty RA patients receiving long-term methotrexate therapy at moderate and severe active stages were selected and treated with TCZ 8 mg/kg/time iv gtt intravenously guttae every 4 weeks. Peripheral blood was extracted before and 24 weeks after TCZ treatment. Peripheral blood mononuclear cells (PBMC) were collected by density gradient centrifugation. Flow cytometry was used to detect the ratio of CD4 naïve T cells and CD4 memory T cells, Th17 cells, and Treg cells in PBMC. DAS28 score, CRP, RF, and CCP levels in patients were evaluated.ResultsCompared with before treatment, IL-6 receptor antagonist TCZ significantly improved patients’ condition, including DAS28 score, CRP, RF, and CCP levels (P<0.01). Furthermore, TCZ obviously upregulated CD4 naïve T cells proportion and decreased CD4 memory T cells ratio (P<0.01). TCZ also markedly reduced the proportion of Th17 cells and increased the proportion of Treg cells (P<0.01).ConclusionsTCZ can treat RA patients through regulating the ratio of CD4 naïve T cells, CD4 memory T cells, Th17 cells, and Treg cells in PBMC.

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Section: Discussionmentioning

confidence: 99%

Interleukin-6 (IL-6) Receptor Antagonist Protects Against Rheumatoid Arthritis

et al. 2016

Med Sci Monit

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“…Intralymphatic histiocytosis (ILH) is a rare cutaneous manifestation of rheumatoid arthtritis (RA) which is characterized by the presence of histiocytes in dilated dermal lymphatic vessels1. We describe here a case of ILH with massive interstitial granulomatous foci mimicking interstitial granulomatous dermatitis (IGD)2 in a patient with RA.…”

mentioning

confidence: 98%

Intralymphatic Histiocytosis with Massive Interstitial Granulomatous Foci in a Patient with Rheumatoid Arthritis

Tanaka¹,

Funasaka²,

Tsuruta³

et al. 2017

Ann Dermatol

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“…Bakr et al provided support for this hypothesis, citing a case in their series where infliximab treatment, a TNF‐α inhibitor, clinically improved ILH lesions 3 . A recent report showed improvement with tocilizumab, an anti‐IL‐6 monoclonal antibody, in a patient with rheumatoid arthritis 42 . Another theory, incorporating anatomical and inflammatory components, is that ILH is caused by lymphatic obstruction combined with antigenic attraction of histiocytes.…”

Section: Discussionmentioning

confidence: 99%

Intralymphatic histiocytosis in healing cellulitis: Case report and review of the literature

Goldsmith

Tahan

2020

J Cutan Pathol

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Intralymphatic histiocytosis (ILH) is a rare skin benign condition observed in a variety of inflammatory settings. It is characterized by the presence of ectatic dermal lymphatic vessels containing aggregates of histiocytes. Associated conditions that have been identified include rheumatoid arthritis, metallic orthopedic implants, inflammatory bowel disease, and malignancies of the breast, skin, and colon. Some cases with no attributable underlying cause have been described. The pathophysiology of ILH is not well understood. It has been proposed that it may represent macrophage migration during immune activation. Herein, we present the first description of ILH observed in the healing phase of cellulitis on the skin of the breast. Awareness of this possibility is important when the diagnosis of intravascular carcinomatosis is being considered.

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Successful Treatment with Tocilizumab in a Case of Intralymphatic Histiocytosis Associated with Rheumatoid Arthritis

Cited by 11 publications

References 9 publications

Interleukin-6 (IL-6) Receptor Antagonist Protects Against Rheumatoid Arthritis

Interleukin-6 (IL-6) Receptor Antagonist Protects Against Rheumatoid Arthritis

Intralymphatic Histiocytosis with Massive Interstitial Granulomatous Foci in a Patient with Rheumatoid Arthritis

Intralymphatic histiocytosis in healing cellulitis: Case report and review of the literature

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