Efficacy of Tocilizumab, a Humanized Neutralizing Antibody Against Interleukin-6 Receptor, in Progressive Renal Injury Associated with Castleman's Disease

Overview

Journal CEN Case Rep

Specialty Nephrology

Date 2017 May 17

PMID 28509146

Citations 4

Authors

Akito Maeshima

Masao Nakasatomi

Daizo Henmi

Shin Yamashita

Yoriaki Kaneko

Takashi Kuroiwa

Keiju Hiromura

Yoshihisa Nojima

Affiliations

Soon will be listed here.

Abstract

Castleman's disease is a benign lymphoproliferative disorder in which interleukin-6 (IL-6), a pleiotropic proinflammatory cytokine, is thought to play a pathogenetic role. Presented is the case of a 72-year-old man with Castleman's disease who exhibited progressive renal dysfunction with proteinuria. Renal biopsy revealed mesangial hypercellularity and matrix expansion in most glomeruli and peritubular inflammatory cell infiltration. Immunofluorescence studies showed intense deposition of IgG in a granular pattern along the glomerular basement membrane. Histological features were compatible with membranoproliferative glomerulonephritis accompanied by interstitial inflammatory cell infiltration. Immunohistological analysis showed that IL-6 was abundantly expressed by tubular cells and interstitial macrophages, suggesting involvement of IL-6 in the renal injury. As a result of administration of tocilizumab, a humanized anti-IL-6 receptor antibody, the patient experienced clinical and biochemical improvement of Castleman's disease, including marked reduction of proteinuria and stabilization of renal function. These findings suggest the efficacy of tocilizumab against Castleman's disease and its renal complications.

Citing Articles

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Decreased chronic kidney disease in rheumatoid arthritis in the era of biologic disease-modifying anti-rheumatic drugs.

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