Diagnostic features of mild cellulitis phlegmon in patients with rheumatoid arthritis treated with tocilizumab: a report of two cases

• Published in: Modern rheumatology Vol. 21; no. 6; pp. 673 - 677
• Main Authors: Hirao, Makoto, Nampei, Akihide, Shi, Kenrin, Yoshikawa, Hideki, Nishimoto, Norihiro, Hashimoto, Jun
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.12.2011; Informa Healthcare
• Subjects: Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Antirheumatic Agents - adverse effects; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - metabolism; C-Reactive Protein - metabolism; Case management; Case Report; Cellulitis - chemically induced; Cellulitis - diagnosis; Cellulitis - metabolism; Drug therapy; Female; Humans; Infections; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Rheumatoid arthritis; Rheumatology; CRP; WBC; Neutrophil; Tocilizumab; Cellulitis phlegmon
• ISSN: 1439-7595; 1439-7609
• DOI: 10.1007/s10165-011-0459-y

Two cases of subcutaneous soft tissue infection in 30 RA patients treated with tocilizumab are reported. In both patients, local redness, swelling, and heat were observed around the affected site. WBC spikes and such local findings were suggested to be clinically useful for the early detection of low-grade subcutaneous infection in RA patients whose disease is tightly controlled with tocilizumab. Of note, the C-reactive protein (CRP) level and temperature lacked clinical utility for such detection.