Evidence map›Paper›PMID 42420531›Full record

ArticleRheumatology international2026

Sarcoidosis-like reaction associated with tocilizumab in a patient with giant cell arteritis: a case based review.

Misako Higashida-Konishi, Shiori Kusano, Hiroki Tabata, Satoshi Hama, Tatsuhiro Oshige, Yuriko Yukino, Keisuke Izumi, Arafumi Maeshima, Yutaka Okano, Hisaji Oshima and 1 more

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In one paragraph

Article in Rheumatology international, 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

11 authors.

Misako Higashida-KonishiDivision of Rheumatology, Department of Medicine, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan. higashidamisako@gmail.com.ORCID http://orcid.org/0000-0001-8712-3852
Shiori KusanoDivision of Rheumatology, Department of Medicine, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.ORCID http://orcid.org/0009-0004-6864-3149
Hiroki TabataDivision of Rheumatology, Department of Medicine, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.ORCID http://orcid.org/0009-0005-0353-1821
Satoshi HamaDivision of Rheumatology, Department of Medicine, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.ORCID http://orcid.org/0009-0005-6150-0548
Tatsuhiro OshigeDivision of Rheumatology, Department of Medicine, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.ORCID http://orcid.org/0009-0004-9967-049X
Yuriko YukinoDivision of Dermatology, NHO Tokyo Medical Center, Tokyo, Japan.ORCID http://orcid.org/0009-0003-9254-2156
Keisuke IzumiDivision of Rheumatology, Department of Medicine, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.ORCID http://orcid.org/0000-0001-8597-0759
Arafumi MaeshimaDivision of Pathology, NHO Tokyo Medical Center, Tokyo, Japan.ORCID http://orcid.org/0009-0005-6174-3857
Yutaka OkanoDivision of Rheumatology, Department of Medicine, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.ORCID http://orcid.org/0000-0003-1373-8840
Hisaji OshimaDivision of Rheumatology, Department of Medicine, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.ORCID http://orcid.org/0000-0002-6808-5907
Katsuya SuzukiDivision of Rheumatology, Department of Medicine, NHO Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.ORCID http://orcid.org/0009-0001-8684-6108

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We report a 71-year-old man with confirmed giant cell arteritis (GCA) who underwent temporal artery biopsy. Following 2.5 years of combination therapy with tocilizumab (TCZ) (162 mg/w) and glucocorticoids (tapered over 2.5 years to prednisolone 1 mg/day), erythematous facial papules and red eye developed. Skin biopsy revealed multiple non-caseating epithelioid granulomas containing multinucleated giant cells, without evidence of infection. Serum angiotensin-converting enzyme levels and soluble interleukin-2 receptor levels were within normal limits, and imaging showed no systemic sarcoidosis involvement. TCZ-induced sarcoidosis-like reaction was suspected. TCZ was discontinued 3 months after the onset of the lesions. Considering the risk of GCA recurrence, PSL was increased to 2 mg/day. The erythematous facial papules and red eye showed improvement 5 months after the onset of the lesions. There was no GCA recurrence. Biologic agents including TCZ are cornerstones in autoimmune disease management but may paradoxically induce immune-mediated reactions, including sarcoidosis-like reactions due to immune dysregulation. A literature search identified 6 previously published cases of TCZ-associated sarcoidosis-like reactions. Among these, ocular involvement in the form of scleritis was observed only in the present case. We should remain vigilant for sarcoidosis-like reaction during TCZ therapy and consider individualized monitoring and treatment adjustment.

Indexed as

Antibodies, Monoclonal, HumanizedGiant Cell ArteritisSarcoidosisAgedBiopsyDrug Therapy, CombinationGlucocorticoidsHumansMaleTreatment OutcomeAntibodies, Monoclonal, HumanizedGlucocorticoidstocilizumabBiological therapyGiant cell arteritisGranulomaSarcoidosisScleritisTocilizumab

Identifiers

PMID42420531

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.