Gastrointestinal Perforation After Treatment With Tocilizumab

Rojo, Mikel; Cano-Valderrama, Óscar; Picazo, Sara; Sáez, Carlos; Gómez, Luis Arruza; Sánchez, Cristina Díaz; Sanz-Ortega, Gonzalo; Torres, Antonio

doi:10.1177/0003134820926481

Cited by 16 publications

(19 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only one of our cases had abdominal pain and tenderness at presentation. Another developed anemia due to active lower GI bleeding which is similar to the case published by Rojo et al [ 21 ] where the patient developed anemia and found to have hemoperitoneum with pericecal hematoma. This is probably explained by the site of perforation since both had cecal perforation.…”

Section: Discussionsupporting

confidence: 84%

See 1 more Smart Citation

Gastrointestinal perforation secondary to COVID-19

Argan¹,

Alqatari²,

Said³

et al. 2021

Medicine

View full text Add to dashboard Cite

Introduction: Corona virus disease-2019 (COVID-19) presents primarily with respiratory symptoms. However, extra respiratory manifestations are being frequently recognized including gastrointestinal involvement. The most common gastrointestinal symptoms are nausea, vomiting, diarrhoea and abdominal pain. Gastrointestinal perforation in association with COVID-19 is rarely reported in the literature. Patient concerns and diagnosis: In this series, we are reporting 3 cases with different presentations of gastrointestinal perforation in the setting of COVID-19. Two patients were admitted with critical COVID-19 pneumonia, both required intensive care, intubation and mechanical ventilation. The first one was an elderly gentleman who had difficult weaning from mechanical ventilation and required tracheostomy. During his stay in intensive care unit, he developed Candidemia without clear source. After transfer to the ward, he developed lower gastrointestinal bleeding and found by imaging to have sealed perforated cecal mass with radiological signs of peritonitis. The second one was an obese young gentleman who was found incidentally to have air under diaphragm. Computed tomography showed severe pneumoperitoneum with cecal and gastric wall perforation. The third case was an elderly gentleman who presented with severe COVID-19 pneumonia along with symptoms and signs of acute abdomen who was confirmed by imaging to have sigmoid diverticulitis with perforation and abscess collection. Interventions: The first 2 cases were treated conservatively. The third one was treated surgically. Outcome: Our cases had a variable hospital course but fortunately all were discharged in a good clinical condition. Conclusion: Our aim from this series is to highlight this fatal complication to clinicians in order to enrich our understanding of this pandemic and as a result improve patients’ outcome.

show abstract

Section: Discussionsupporting

confidence: 84%

“…[ 20 ] In addition, Rojo et al reported presence of microthrombi and wall necrosis in the pathology examination of his COVID-19 case with bowel perforation. [ 21 ] Other possible implicating factors are the use of Tocilizumab and high dose steroids. [ 21 , 31 ] Both are indicated in severe and critically ill COVID-19 cases.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal perforation secondary to COVID-19

Argan¹,

Alqatari²,

Said³

et al. 2021

Medicine

View full text Add to dashboard Cite

show abstract

“…Superior mesenteric artery thrombosis is a rare and atypical manifestation of COVID-19 necessitating long-term recovery [136]. Cases of bowel perforation attributed to tocilizumab were reported [137].…”

Section: Gastrointestinal System and Livermentioning

confidence: 99%

Epidemiology and organ specific sequelae of post-acute COVID19: A narrative review

Korompoki

Gavriatopoulou

Hicklen

et al. 2021

Journal of Infection

130

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

“…239 Gastrointestinal perforations were also recently reported under tocilizumab treatment. 240 Therefore, it is difficult to evaluate the clinical efficacy of TCZ.…”

Section: Il-6mentioning

confidence: 99%

Immune responses during COVID-19 infection

et al. 2020

View full text Add to dashboard Cite

Over the past 16 years, three coronaviruses (CoVs), severe acute respiratory syndrome CoV (SARS-CoV) in 2002, Middle East respiratory syndrome CoV (MERS-CoV) in 2012 and 2015, and SARS-CoV-2 in 2020, have been causing severe and fatal human epidemics. The unpredictability of coronavirus disease-19 (COVID-19) poses a major burden on health care and economic systems across the world. This is caused by the paucity of in-depth knowledge of the risk factors for severe COVID-19, insufficient diagnostic tools for the detection of SARS-CoV-2, as well as the absence of specific and effective drug treatments. While protective humoral and cellular immune responses are usually mounted against these betacoronaviruses, immune responses to SARS-CoV2 sometimes derail towards inflammatory tissue damage, leading to rapid admissions to intensive care units. The lack of knowledge on mechanisms that tilt the balance between these two opposite outcomes poses major threats to many ongoing clinical trials dealing with immunostimulatory or immunoregulatory therapeutics. This review will discuss innate and cognate immune responses underlying protective or deleterious immune reactions against these pathogenic coronaviruses.

show abstract

Gastrointestinal Perforation After Treatment With Tocilizumab

Cited by 16 publications

References 3 publications

Gastrointestinal perforation secondary to COVID-19

Gastrointestinal perforation secondary to COVID-19

Epidemiology and organ specific sequelae of post-acute COVID19: A narrative review

Immune responses during COVID-19 infection

Contact Info

Product

Resources

About