肺病変を伴う全身性Castleman病におけるヒト型抗IL-6レセプター抗体 (tocilitumab) の長期使用経験

摘要: A 27-year-old man was admitted to our hospital with the complaint of general fatigue. He had cervical and mediastinal lymphadenopathy. Laboratory examination revealed anemia, hypergammaglobulinemia, increased levels C-reactive protein (CRP) erythrocyte sedimentation rate (ESR). chest radiograph showed opacities in both lung fields. Pathological findings from thoracoscopic lymph node biopsies were compatible multicentric Castleman's disease (MCD), plasma cell type pulmonary involvement. Chemotherapy combined radiation therapy resulted no improvement his lymphadenopathy inflammatory symptoms. Eight mg/kg humanized anti-human IL-6 receptor antibody (tocilitumab) thus administered biweekly. Soon after initiating tocilitumab treatment, patient's fatigue disappeared, CRP, ESR, hypergammaglobulinemia all improved remarkably. Further treatment for two years maintenance this good response without any severe adverse events, but obvious improvement. Tocilitumab effective MCD patient, however its influence on concurrent needs be investigated further.