Successful Treatment of a Patient with Rheumatoid Arthritis and IgA-Kappa Multiple Myeloma with Tocilizumab

Yasushi Matsuyama; Takao Nagashima; Kyoko Honne; Yasuyuki Kamata; Masahiro Iwamoto; Hitoaki Okazaki; Kazuya Sato; Keiya Ozawa; Seiji Minota

doi:10.2169/internalmedicine.50.4636

CASE REPORTS

Successful Treatment of a Patient with Rheumatoid Arthritis and IgA-Kappa Multiple Myeloma with Tocilizumab

Yasushi Matsuyama, Takao Nagashima, Kyoko Honne, Yasuyuki Kamata, Masahiro Iwamoto, Hitoaki Okazaki, Kazuya Sato, Keiya Ozawa, Seiji Minota

Author information

Yasushi Matsuyama
Division of Rheumatology and Clinical Immunology, Jichi Medical University, Japan
Takao Nagashima
Division of Rheumatology and Clinical Immunology, Jichi Medical University, Japan
Kyoko Honne
Division of Rheumatology and Clinical Immunology, Jichi Medical University, Japan
Yasuyuki Kamata
Division of Rheumatology and Clinical Immunology, Jichi Medical University, Japan
Masahiro Iwamoto
Division of Rheumatology and Clinical Immunology, Jichi Medical University, Japan
Hitoaki Okazaki
Division of Rheumatology and Clinical Immunology, Jichi Medical University, Japan
Kazuya Sato
Division of Hematology, Jichi Medical University, Japan
Keiya Ozawa
Division of Hematology, Jichi Medical University, Japan
Seiji Minota
Division of Rheumatology and Clinical Immunology, Jichi Medical University, Japan

Keywords: tocilizumab, interleukin-6, rheumatoid arthritis, multiple myeloma

JOURNAL OPEN ACCESS

2011 Volume 50 Issue 6 Pages 639-642

DOI https://doi.org/10.2169/internalmedicine.50.4636

Details

Abstract

A 63-year-old woman receiving tumor necrosis factor (TNF) inhibitors for rheumatoid arthritis (RA) was found to have smoldering IgA-kappa type multiple myeloma (MM). Retrospective examination of stored serum samples revealed a steady increase of serum IgA levels after the start of TNF inhibitor therapy. The patient's articular symptoms showed marked exacerbation when TNF inhibitors were discontinued because of fear of worsening the MM. Tocilizumab improved RA symptoms dramatically and stabilized serum IgA levels for 13 months after a transient steep rise. This case suggests that tocilizumab can be used safely in patients with inflammatory disorders with coexisting MM.

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