Case Report: Intra-articular injection of tocilizumab for arthritis treatment in chronic graft-vs.-host disease
BackgroundChronic graft-vs.-host disease (cGVHD) is a major complication of allogeneic hematopoietic cell transplantation. It is a leading cause of long-term morbidity, non-relapse mortality, and impaired health-related quality of life. cGVHD is a multifactorial syndrome that can manifest with artic...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1515706/full |
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| author | Mingyu Xie Mingyu Xie Mingyu Xie Qin Liu Huiting Yuan Yumei Chen Xian Zou Zhenhong Zhang Zhenhong Zhang Baimao Zhong Baimao Zhong Huasong Zeng Haisheng Zeng Haisheng Zeng |
| author_facet | Mingyu Xie Mingyu Xie Mingyu Xie Qin Liu Huiting Yuan Yumei Chen Xian Zou Zhenhong Zhang Zhenhong Zhang Baimao Zhong Baimao Zhong Huasong Zeng Haisheng Zeng Haisheng Zeng |
| author_sort | Mingyu Xie |
| collection | DOAJ |
| description | BackgroundChronic graft-vs.-host disease (cGVHD) is a major complication of allogeneic hematopoietic cell transplantation. It is a leading cause of long-term morbidity, non-relapse mortality, and impaired health-related quality of life. cGVHD is a multifactorial syndrome that can manifest with articular involvement. Approximately 50% of cGVHD survivors do not respond to glucocorticoid therapy used for arthritis. Subsequently, we shall present a case of a juvenile patient with arthritis and cGVHD, who responded well to intra-articular injection of tocilizumab, after bone marrow transplantation.Case pressentationA male adolescent with acute myeloid leukemia successfully underwent marrow stem cell transplantation. However, he developed arthritis in the elbow and knee joints and had difficulty walking more than 3 months after transplantation. He was administered anti-rejection drugs with cyclosporine, ruxolitinib, and methylprednisolone by his physician, which did not work. He was subsequently treated with intravenous tocilizumab under the supervision of his rheumatologist. Although his clinical symptoms showed remission at early stages, his knee joints were more swollen, and he could not stand after being infected with COVID-19. Both of his knee joints was injected with tocilizumab at 0, 2, 4, 6, 7, 11, and 19 weeks. Interleukin (IL)-6 levels in the peripheral blood continuously decreased. After treatment for 4 months, the patient could walk a few hundred meters with minimal exertion.ConclusionAn intra-articular injection of tocilizumab could be a viable treatment option for arthritis; however, large-scale clinical trials are warranted to confirm its efficacy. |
| format | Article |
| id | doaj-art-e7f412fee76e4702873c7ca01d54e705 |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-e7f412fee76e4702873c7ca01d54e7052025-08-20T03:33:21ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-07-011310.3389/fped.2025.15157061515706Case Report: Intra-articular injection of tocilizumab for arthritis treatment in chronic graft-vs.-host diseaseMingyu Xie0Mingyu Xie1Mingyu Xie2Qin Liu3Huiting Yuan4Yumei Chen5Xian Zou6Zhenhong Zhang7Zhenhong Zhang8Baimao Zhong9Baimao Zhong10Huasong Zeng11Haisheng Zeng12Haisheng Zeng13Department of Pediatric Rheumatology and Immunology, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaRare Diseases Diagnosis & Treatment Center, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaAccurate Diagnosis & Key Laboratory of Rare Disease in Children, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaDepartment of Pediatric Rheumatology and Immunology, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaDepartment of Pediatric Rheumatology and Immunology, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaDepartment of Pediatric Rheumatology and Immunology, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaDepartment of Pediatric Rheumatology and Immunology, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaDepartment of Pediatric Rheumatology and Immunology, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaAccurate Diagnosis & Key Laboratory of Rare Disease in Children, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaRare Diseases Diagnosis & Treatment Center, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaAccurate Diagnosis & Key Laboratory of Rare Disease in Children, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaDepartment of Pediatric Allergy, Immunology & Rheumatology, Women and Children’s Medical Center, Guangzhou Medical University, Center and South National Pediatric Medical Center, Guangzhou, ChinaDepartment of Pediatric Rheumatology and Immunology, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaAccurate Diagnosis & Key Laboratory of Rare Disease in Children, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong, ChinaBackgroundChronic graft-vs.-host disease (cGVHD) is a major complication of allogeneic hematopoietic cell transplantation. It is a leading cause of long-term morbidity, non-relapse mortality, and impaired health-related quality of life. cGVHD is a multifactorial syndrome that can manifest with articular involvement. Approximately 50% of cGVHD survivors do not respond to glucocorticoid therapy used for arthritis. Subsequently, we shall present a case of a juvenile patient with arthritis and cGVHD, who responded well to intra-articular injection of tocilizumab, after bone marrow transplantation.Case pressentationA male adolescent with acute myeloid leukemia successfully underwent marrow stem cell transplantation. However, he developed arthritis in the elbow and knee joints and had difficulty walking more than 3 months after transplantation. He was administered anti-rejection drugs with cyclosporine, ruxolitinib, and methylprednisolone by his physician, which did not work. He was subsequently treated with intravenous tocilizumab under the supervision of his rheumatologist. Although his clinical symptoms showed remission at early stages, his knee joints were more swollen, and he could not stand after being infected with COVID-19. Both of his knee joints was injected with tocilizumab at 0, 2, 4, 6, 7, 11, and 19 weeks. Interleukin (IL)-6 levels in the peripheral blood continuously decreased. After treatment for 4 months, the patient could walk a few hundred meters with minimal exertion.ConclusionAn intra-articular injection of tocilizumab could be a viable treatment option for arthritis; however, large-scale clinical trials are warranted to confirm its efficacy.https://www.frontiersin.org/articles/10.3389/fped.2025.1515706/fullcGVHDtocilizumabarthritisintra-articular injectionCase Report |
| spellingShingle | Mingyu Xie Mingyu Xie Mingyu Xie Qin Liu Huiting Yuan Yumei Chen Xian Zou Zhenhong Zhang Zhenhong Zhang Baimao Zhong Baimao Zhong Huasong Zeng Haisheng Zeng Haisheng Zeng Case Report: Intra-articular injection of tocilizumab for arthritis treatment in chronic graft-vs.-host disease Frontiers in Pediatrics cGVHD tocilizumab arthritis intra-articular injection Case Report |
| title | Case Report: Intra-articular injection of tocilizumab for arthritis treatment in chronic graft-vs.-host disease |
| title_full | Case Report: Intra-articular injection of tocilizumab for arthritis treatment in chronic graft-vs.-host disease |
| title_fullStr | Case Report: Intra-articular injection of tocilizumab for arthritis treatment in chronic graft-vs.-host disease |
| title_full_unstemmed | Case Report: Intra-articular injection of tocilizumab for arthritis treatment in chronic graft-vs.-host disease |
| title_short | Case Report: Intra-articular injection of tocilizumab for arthritis treatment in chronic graft-vs.-host disease |
| title_sort | case report intra articular injection of tocilizumab for arthritis treatment in chronic graft vs host disease |
| topic | cGVHD tocilizumab arthritis intra-articular injection Case Report |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1515706/full |
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