AI Article Synopsis
- A 64-year-old woman with progressive AA amyloidosis related to rheumatoid arthritis was hospitalized due to hypovolemic shock, which improved with intensive care treatment.
- After the initial treatment, paralytic ileus emerged instead of diarrhea, indicating advanced stages of the condition.
- Tocilizumab was administered and led to rapid normalization of serum AA levels and improvement in symptoms, ultimately resulting in a biopsy showing no amyloid deposition after three treatments.
Article Abstract
A 64-year-old woman suffering from progressive amyloid A (AA) amyloidosis of the gastrointestinal (GI) tract, associated with active rheumatoid arthritis, was transferred to our hospital due to hypovolemic shock. Although intensive care, including treatment with prednisolone and methotrexate, improved the hypovolemic shock, paralytic ileus became dominant instead of the marked diarrhea, suggesting the terminal stage of AA amyloidosis of the GI tract. Thus, we administered tocilizumab, a humanized anti-interleukin 6 receptor antibody (8 mg/kg, repeated every 4 weeks). Two weeks after the first injection of tocilizumab, serum AA rapidly returned to their normal ranges in accordance with the amelioration of paralytic ileus and systemic joint pain. Surprisingly, after three courses of tocilizumab treatment, colon biopsy revealed no amyloid deposition. Tocilizumab is a promising agent to treat secondary AA amyloidosis by strongly suppressing serum AA levels.
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| http://dx.doi.org/10.1007/s10067-010-1422-6 | DOI Listing |
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