Desensitization to Tocilizumab in a Patient With Juvenile Idiopathic Arthritis
Abstract
Juvenile idiopathic arthritis is the most common chronic inflammatory rheumatic disease in children, classified by the number of affected joints, systemic symptoms, and rheumatoid factor presence. We describe the case of an eight-year-old female with extended oligoarticular juvenile idiopathic arthritis and a strong family history of atopy who developed a Grade II hypersensitivity reaction during a tocilizumab infusion after four years of treatment. Symptoms, including rash, urticaria on the neck and arms, periauricular edema, tachycardia, and hypertension, emerged within 30 minutes of infusion. The reaction was managed with intramuscular epinephrine, intravenous hydrocortisone, and saline, leading to symptom resolution. Skin prick testing was negative, but intradermal testing showed a positive reaction. Due to the drug's effectiveness in controlling her disease, a desensitization protocol was initiated, involving a 12-step, 5.67-hour infusion schedule with premedication every four weeks. This case highlights the importance of desensitization protocols in patients requiring continued monoclonal antibody therapy despite hypersensitivity reactions.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Artificial Intelligence in Medicine: Cross-Sectional Study Among Medical Students on Application, Education, and Ethical Aspects
- Information quality of videos related to esophageal cancer on tiktok, kwai, and bilibili: a cross-sectional study
- The quality and reliability of short videos about hypertension on TikTok: a cross-sectional study
- Quality and reliability evaluation of pancreatic cancer-related video content on social short video platforms: a cross-sectional study
- Quality and reliability of pediatric pneumonia related short videos on mainstream platforms: cross-sectional study
- Association between metabolic score for insulin resistance (METS-IR) and hypertension: a cross-sectional study based on NHANES 2007–2018
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.