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Open Access Highly Accessed Case Report

Risk of significant cytopenias after treatment with tocilizumab in systemic juvenile arthritis patients with a history of macrophage activation syndrome

Elizabeth A Kessler1, Sheetal S Vora1 and James W Verbsky1,2*

Author Affiliations

1 Division of Rheumatology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA

2 Children’s Corporate Center, Suite C465 9000 West Wisconsin Avenue, Milwaukee, WI 53226, USA

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Pediatric Rheumatology 2012, 10:30 doi:10.1186/1546-0096-10-30

Published: 29 August 2012

Abstract

Tocilizumab (TCZ) is the first FDA- approved treatment for systemic juvenile idiopathic arthritis (sJIA). We report 3 cases of cytopenias in children with sJIA treated with TCZ. Two of the children who developed significant cytopenias shortly after initiation of TCZ had a history of macrophage activation syndrome. We raise the possibility that patients with a tendency towards MAS have an increased risk of developing cytopenias when treated with tocilizumab.

Keywords:
Juvenile idiopathic arthritis; Macrophage activation syndrome; Tocilizumab