Nonspecific interstitial pneumonia in refractory systemic juvenile idiopathic arthritis responded to tocilizumab treatment

Asian Pac J Allergy Immunol. 2022 Jun;40(2):172-176. doi: 10.12932/AP-050819-0616.

Abstract

Background: Nonspecific interstitial pneumonia (NSIP) is a rare pulmonary complication in systemic juvenile idiopathic arthritis (SJIA).

Objective: To present a case with NSIP in SJIA.

Methods: Case report.

Results: We report the case of a 4-year-old boy with SJIA complicated by macrophage activation syndrome (MAS) refractory to conventional therapy, and who later developed NSIP confirmed by high-resolution computerized tomography of the chest and lung histopathology. The patient received tocilizumab, a monoclonal antibody to interleukin-6 receptor, to control his disease. Data relating to tocilizumab treatment of NSIP in refractory SJIA is limited.

Conclusions: The data from this case report suggests that NSIP could be a pulmonary complication of SJIA complicated by MAS that is refractory to conventional therapy. Early initiation of tocilizumab should be considered to achieve disease remission in this pediatric patient population.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Arthritis, Juvenile* / complications
  • Arthritis, Juvenile* / drug therapy
  • Child
  • Child, Preschool
  • Humans
  • Lung Diseases, Interstitial* / complications
  • Lung Diseases, Interstitial* / etiology
  • Macrophage Activation Syndrome* / complications
  • Male

Substances

  • Antibodies, Monoclonal, Humanized
  • tocilizumab