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Bowel ulceration following tocilizumab administration in a COVID-19 patient.

ABSTRACT: 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.

SUBMITTER: Bruce-Hickman D

PROVIDER: S-EPMC7437943 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Bowel ulceration following tocilizumab administration in a COVID-19 patient.

Bruce-Hickman Damian D Sajeed Shanaz Matthew SM Pang Yin Huei YH Seow Choon Sheong CS Chen Weihao W Gulati Kansal Monika M

BMJ open gastroenterology 20200801 1

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 exposu ...[more]

PMID: 32816957

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