Bowel ulceration following tocilizumab administration in a COVID-19 patient

Tocilizumab, a monoclonal antibody against interleukin-6, has been used to treat cytokine release syndrome (CRS) in a subset of patients with severe COVID-19 disease. Acute ulcerative bowel disease has been only rarely documented in patients treated for rheumatological conditions. The gastrointestin...

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Autores principales: Bruce-Hickman, Damian, Sajeed, Shanaz Matthew, Pang, Yin Huei, Seow, Choon Sheong, Chen, Weihao, Gulati Kansal, Monika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437943/
https://www.ncbi.nlm.nih.gov/pubmed/32816957
http://dx.doi.org/10.1136/bmjgast-2020-000484
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author Bruce-Hickman, Damian
Sajeed, Shanaz Matthew
Pang, Yin Huei
Seow, Choon Sheong
Chen, Weihao
Gulati Kansal, Monika
author_facet Bruce-Hickman, Damian
Sajeed, Shanaz Matthew
Pang, Yin Huei
Seow, Choon Sheong
Chen, Weihao
Gulati Kansal, Monika
author_sort Bruce-Hickman, Damian
collection PubMed
description Tocilizumab, a monoclonal antibody against interleukin-6, has been used to treat cytokine release syndrome (CRS) in a subset of patients with severe COVID-19 disease. Acute ulcerative bowel disease has been only rarely documented in patients treated for rheumatological conditions. The gastrointestinal side effects seen when used in the context of COVID-19 are unknown. We present a case of COVID-19 CRS in which acute terminal ileum and perforated caecal ulceration evolved after tocilizumab exposure. We raise awareness of a possible causal relationship between even a single dose of tocilizumab and gut ulceration in patients with COVID-19. Any such drug enteropathy relationship requires watchful monitoring during upcoming trials of tocilizumab in patients with COVID-19.
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spelling pubmed-74379432020-08-24 Bowel ulceration following tocilizumab administration in a COVID-19 patient Bruce-Hickman, Damian Sajeed, Shanaz Matthew Pang, Yin Huei Seow, Choon Sheong Chen, Weihao Gulati Kansal, Monika BMJ Open Gastroenterol Case Report Tocilizumab, a monoclonal antibody against interleukin-6, has been used to treat cytokine release syndrome (CRS) in a subset of patients with severe COVID-19 disease. Acute ulcerative bowel disease has been only rarely documented in patients treated for rheumatological conditions. The gastrointestinal side effects seen when used in the context of COVID-19 are unknown. We present a case of COVID-19 CRS in which acute terminal ileum and perforated caecal ulceration evolved after tocilizumab exposure. We raise awareness of a possible causal relationship between even a single dose of tocilizumab and gut ulceration in patients with COVID-19. Any such drug enteropathy relationship requires watchful monitoring during upcoming trials of tocilizumab in patients with COVID-19. BMJ Publishing Group 2020-08-18 /pmc/articles/PMC7437943/ /pubmed/32816957 http://dx.doi.org/10.1136/bmjgast-2020-000484 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Case Report
Bruce-Hickman, Damian
Sajeed, Shanaz Matthew
Pang, Yin Huei
Seow, Choon Sheong
Chen, Weihao
Gulati Kansal, Monika
Bowel ulceration following tocilizumab administration in a COVID-19 patient
title Bowel ulceration following tocilizumab administration in a COVID-19 patient
title_full Bowel ulceration following tocilizumab administration in a COVID-19 patient
title_fullStr Bowel ulceration following tocilizumab administration in a COVID-19 patient
title_full_unstemmed Bowel ulceration following tocilizumab administration in a COVID-19 patient
title_short Bowel ulceration following tocilizumab administration in a COVID-19 patient
title_sort bowel ulceration following tocilizumab administration in a covid-19 patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437943/
https://www.ncbi.nlm.nih.gov/pubmed/32816957
http://dx.doi.org/10.1136/bmjgast-2020-000484
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