Leukoencephalopathy with Cognitive Impairment following Tocilizumab for the Treatment of Rheumatoid Arthritis (RA)
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- Kobayashi Katsuya
- Department of Neurology, Kyoto University Hospital
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- Okamoto Yoko
- Department of Neurology, Kyoto University Hospital
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- Inoue Haruhisa
- Department of Neurology, Kyoto University Hospital
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- Usui Takashi
- Department of Rheumatology and Clinical Immunology, Kyoto University Hospital
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- Ihara Masafumi
- Department of Neurology, Kyoto University Hospital
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- Kawamata Jun
- Department of Neurology, Kyoto University Hospital
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- Miki Yukio
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital
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- Mimori Tsuneyo
- Department of Rheumatology and Clinical Immunology, Kyoto University Hospital
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- Tomimoto Hidekazu
- Department of Neurology, Mie University Hospital
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- Takahashi Ryosuke
- Department of Neurology, Kyoto University Hospital
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Abstract
The biological agent tocilizumab, is a humanized, anti-human interleukin-6 receptor antibody. A 72-year-old woman developed cognitive impairment during the Phase III clinical trial of tocilizumab for the treatment of rheumatoid arthritis. MRI demonstrated hyperintense dissemination throughout the white matter on T2WI. An initial diagnosis of possible progressive multifocal leukoencephalopathy was made, but the PCR for JC virus DNA was negative in the CSF. The leukoencephalopathy might have been caused by a mechanism related to tocilizumab itself. It is strongly recommended to perform MRI if a patient develops any cognitive impairment during tocilizumab therapy.<br>
Journal
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- Internal Medicine
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Internal Medicine 48 (15), 1307-1309, 2009
The Japanese Society of Internal Medicine