Biologic Rescue With Tocilizumab: A Case of Refractory Chronic Pericardial Effusion in Systemic Sclerosis.

Ramses Delgadillo, Elliot Roufeh, Bianca Lavelle, Kaylin Nguyen, Angelo de la Rosa

Abstract readCase Reports

In one paragraph

Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Ramses DelgadilloDepartment of Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA. Electronic address: Rdelgadillo2@dhs.lacounty.gov.

Elliot RoufehDepartment of Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA.

Bianca LavelleDivision of Cardiology, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA.

Kaylin NguyenDivision of Cardiology, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA.

Angelo de la RosaDivision of Cardiology, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPericardial effusions in systemic sclerosis (SSc) are usually mild; large or refractory effusions are rare. CASE SUMMARY: A 63-year-old woman with diffuse cutaneous SSc, interstitial lung disease, and secondary Sjögren syndrome presented with worsening dyspnea and a large chronic pericardial effusion. Despite pericardiocentesis, drain repositioning, colchicine, corticosteroids, and surgical pericardial window, she had persistent high-output drainage. Tocilizumab, an interleukin-6 (IL-6) receptor antagonist, was initiated for suspected autoimmune serositis, resulting in rapid decline in pericardial drain output and sustained improvement on serial transthoracic echocardiography. DISCUSSION: This case highlights IL-6-driven inflammatory serositis as a mechanism of refractory pericardial effusion in SSc and demonstrates the therapeutic benefit of IL-6 receptor blockade. TAKE-HOME MESSAGE: IL-6-mediated serositis should be considered in refractory SSc effusions; tocilizumab may be effective when standard therapies fail.

Indexed as

autoimmuneechocardiographypericardial effusionpostoperativeright ventricletamponade

Identifiers

PMID41774032

DOI10.1016/j.jaccas.2026.107252

PMCPMC13080666

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LicenceCC BY-NC-ND

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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.