Evidence map›Paper›PMID 32337656›Full record

ArticleCEN case reports2020

Tocilizumab-induced immunocomplex glomerulonephritis: a report of two cases.

Daichi Fukaya, Tsutomu Inoue, Yuta Kogure, Hiroshi Kajiyama, Keisuke Ishizawa, Takeru Seto, Hajime Hasegawa, Toshihide Mimura, Hirokazu Okada

Abstract readCase Reports
In one paragraph

Article in CEN case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Daichi FukayaDepartment of Nephrology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
Tsutomu InoueDepartment of Nephrology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
Yuta KogureDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Hiroshi KajiyamaDepartment of Rheumatology and Applied Immunology, Saitama Medical University, Iruma-gun, Saitama, Japan.
Keisuke IshizawaDivision of Diagnostic Pathology and Department of Pathology, Saitama Medical University, Iruma-gun, Saitama, Japan.
Takeru SetoDepartment of Nephrology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
Hajime HasegawaDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Toshihide MimuraDepartment of Rheumatology and Applied Immunology, Saitama Medical University, Iruma-gun, Saitama, Japan.
Hirokazu OkadaDepartment of Nephrology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan. hirookda@saitama-med.ac.jp.
Saitama Medical University · JPSocial Insurance Saitama Chuo Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We report here two cases of membranoproliferative glomerulonephritis that developed during treatment of rheumatoid arthritis with tocilizumab. In both cases, the initial findings were proteinuria and haematuria, followed by development of bilateral lower leg oedema. One of the patients was weakly positive for anti-nuclear antibody; both had hypocomplementaemia. The patients' renal impairment gradually resolved with discontinuation of tocilizumab followed by treatment with moderate doses of oral prednisolone. Pathological examination of renal biopsies resulted in diagnoses of immunocomplex glomerulonephritis and immunofluorescence staining revealed depositions of IgG, IgA, and IgM, accompanied by C3. Tocilizumab rarely induces autoimmune disorders; therefore, the underlying mechanism is unknown. One patient with immunocomplex glomerulonephritis that may have been associated with tocilizumab therapy for rheumatoid arthritis has been reported previously; that patient and our two are similar in their clinical courses and pathological findings. We conclude that such glomerulonephritis can occur during tocilizumab treatment, but this is rare. Clinicians should be aware of the possibility of paradoxical development of autoimmune diseases during tocilizumab therapy.

Indexed as

Administration, OralAgedAntibodies, AntinuclearAntibodies, Monoclonal, HumanizedAnti-Inflammatory AgentsArthritis, RheumatoidAsian PeopleComplement System ProteinsEdemaFatal OutcomeFemaleGlomerulonephritis, MembranoproliferativeHematuriaHumansLower ExtremityMaleAntibodies, AntinuclearAntibodies, Monoclonal, HumanizedAnti-Inflammatory AgentsComplement System ProteinsPrednisolonetocilizumabGlomerulonephritisRheumatoid arthritisTocilizumab

Identifiers

PMID32337656
PMCPMC7502087
OpenAlexW3019531334

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.