HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Tocilizumab for AA Amyloidosis after Treatment of Multicentric Castleman Disease with Steroids, Chemotherapy and Rituximab for Over 20 Years.

Abstract
We herein report the long-term outcome (30 years) of a human immunodeticiency virus- and human herpesvirus 8-negative Japanese man who was diagnosed to have multicentric Castleman disease (MCD) of the plasmacytic type after investigation of generalized lymphadenopathy at 34 of age in 1983. He received chemotherapy based on lymphoma regimens (combinations of prednisolone, vincristine, vindesine, cyclophosphamide, etoposide, melphalan, and ranimustine, etc.) for over 20 years. Although the systemic lymphadenopathy resolved, AA amyloidosis-related nephropathy occurred, with a serum creatinine (Cre) level of 0.9 mg/dL and urinary protein excretion (UP) of 7.5 g daily. Rituximab was started, but Cre increased to 2.6 mg/dL in 2010 and UP was unchanged. Therefore, treatment with tocilizmab was started. As a result, his hypergammaglobulinemia was well controlled, C-reactive protein became normal, UP decreased to 3.5 g daily, and Cre remained at 2.5 mg/dL in 2013. When AA amyloid nephropathy occurred after long-term chemotherapy, lituximab could not control it, but tocilizmab stopped the progression of nephropathy. This case suggests that MCD and AA amyloidosis may both have a close relationship to the overproduction of interleukin-6.
AuthorsTakashi Iijima, Junichi Hoshino, Tatsuya Suwabe, Keiichi Sumida, Koki Mise, Masahiro Kawada, Toshiharu Ueno, Satoshi Hamanoue, Noriko Hayami, Rikako Hiramatsu, Naoki Sawa, Kenmei Takaichi, Yoshifumi Ubara
JournalInternal medicine (Tokyo, Japan) (Intern Med) Vol. 54 Issue 24 Pg. 3215-9 ( 2015) ISSN: 1349-7235 [Electronic] Japan
PMID26666616 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Monoclonal, Humanized
  • Steroids
  • Rituximab
  • C-Reactive Protein
  • tocilizumab
Topics
  • Amyloidosis (chemically induced, drug therapy)
  • Antibodies, Monoclonal, Humanized (therapeutic use)
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • C-Reactive Protein (biosynthesis)
  • Castleman Disease (drug therapy)
  • Disease Progression
  • Humans
  • Kidney Diseases (chemically induced, drug therapy)
  • Male
  • Middle Aged
  • Rituximab (adverse effects)
  • Steroids (adverse effects)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: