Bowel ulceration following tocilizumab administration in a COVID-19 patient
Tocilizumab, a monoclonal antibody against interleukin-6, has been used to treat cytokine release syndrome (CRS) in a subset of patients with severe COVID-19 disease. Acute ulcerative bowel disease has been only rarely documented in patients treated for rheumatological conditions. The gastrointestin...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-12-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/7/1/e000484.full |
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| author | Damian Bruce-Hickman Shanaz Matthew Sajeed Yin Huei Pang Choon Sheong Seow Weihao Chen Monika Gulati Kansal |
| author_facet | Damian Bruce-Hickman Shanaz Matthew Sajeed Yin Huei Pang Choon Sheong Seow Weihao Chen Monika Gulati Kansal |
| author_sort | Damian Bruce-Hickman |
| collection | DOAJ |
| description | Tocilizumab, a monoclonal antibody against interleukin-6, has been used to treat cytokine release syndrome (CRS) in a subset of patients with severe COVID-19 disease. Acute ulcerative bowel disease has been only rarely documented in patients treated for rheumatological conditions. The gastrointestinal side effects seen when used in the context of COVID-19 are unknown. We present a case of COVID-19 CRS in which acute terminal ileum and perforated caecal ulceration evolved after tocilizumab exposure. We raise awareness of a possible causal relationship between even a single dose of tocilizumab and gut ulceration in patients with COVID-19. Any such drug enteropathy relationship requires watchful monitoring during upcoming trials of tocilizumab in patients with COVID-19. |
| format | Article |
| id | doaj-art-0263cfb18a504b66b690a34c72947587 |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2020-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-0263cfb18a504b66b690a34c729475872024-12-14T19:00:09ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742020-12-017110.1136/bmjgast-2020-000484Bowel ulceration following tocilizumab administration in a COVID-19 patientDamian Bruce-Hickman0Shanaz Matthew Sajeed1Yin Huei Pang2Choon Sheong Seow3Weihao Chen4Monika Gulati Kansal5Intensive Care Medicine, Ng Teng Fong General Hospital, National University Health System, SingaporeIntensive Care Medicine, Ng Teng Fong General Hospital, National University Health System, SingaporeDepartment of Pathology, National University Hospital, SingaporeDepartment of General Surgery, Ng Teng Fong General Hospital, National University Health System, SingaporeGastroenterology and Hepatology, Ng Teng Fong General Hospital, National University Health System, SingaporeIntensive Care Medicine, Ng Teng Fong General Hospital, National University Health System, SingaporeTocilizumab, a monoclonal antibody against interleukin-6, has been used to treat cytokine release syndrome (CRS) in a subset of patients with severe COVID-19 disease. Acute ulcerative bowel disease has been only rarely documented in patients treated for rheumatological conditions. The gastrointestinal side effects seen when used in the context of COVID-19 are unknown. We present a case of COVID-19 CRS in which acute terminal ileum and perforated caecal ulceration evolved after tocilizumab exposure. We raise awareness of a possible causal relationship between even a single dose of tocilizumab and gut ulceration in patients with COVID-19. Any such drug enteropathy relationship requires watchful monitoring during upcoming trials of tocilizumab in patients with COVID-19.https://bmjopengastro.bmj.com/content/7/1/e000484.full |
| spellingShingle | Damian Bruce-Hickman Shanaz Matthew Sajeed Yin Huei Pang Choon Sheong Seow Weihao Chen Monika Gulati Kansal Bowel ulceration following tocilizumab administration in a COVID-19 patient BMJ Open Gastroenterology |
| title | Bowel ulceration following tocilizumab administration in a COVID-19 patient |
| title_full | Bowel ulceration following tocilizumab administration in a COVID-19 patient |
| title_fullStr | Bowel ulceration following tocilizumab administration in a COVID-19 patient |
| title_full_unstemmed | Bowel ulceration following tocilizumab administration in a COVID-19 patient |
| title_short | Bowel ulceration following tocilizumab administration in a COVID-19 patient |
| title_sort | bowel ulceration following tocilizumab administration in a covid 19 patient |
| url | https://bmjopengastro.bmj.com/content/7/1/e000484.full |
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