Necrotizing fasciitis in a patient with rheumatoid arthritis treated with tocilizumab

Sequential Sensing by TLR2 and Mincle Directs Immature Myeloid Cells to Protect against Invasive Group A Streptococcal Infection in Mice

“…Although IL-6 production is known to occur following severe invasive GAS infection in humans (Wang et al, 2008;Yoshizawa et al, 2019), the exact roles of IL-6 during GAS infection remain controversial in both mice and human studies (De Benedetti et al, 2012;Klein et al, 2007;Norrby-Teglund et al, 1995;van de Sande and van Slobbe-Bijlsma, 2012;Yoshida et al, 2012). We show here that gIMC-derived IL-6 is vital for directing Mincle expression for prompt IFN-g production, which subsequently contributes to the clearance of GAS.…”

Development of Necrotising Fasciitis in a Patient Treated for Rheumatoid Arthritis with Tocilizumab

“…Mild adverse events may often be overlooked and these may lead to lethal complications. We have identified 2 other published reports that have evaluated NF in patients who were treated with tocilizumab for RA (8,9). In those cases, it was difficult to make an initial diagnosis of NF because the patients lacked typical laboratory findings, such as elevated CRP and white blood cell count.…”

Necrotising soft tissue infection without systemic toxicity in a patient with rheumatoid arthritis treated with tocilizumab

“…With regard to the previous five cases, the time from the last infusion to clinical manifestation was available for only two cases. In a case wherein the last administration of tocilizumab was 2 weeks before onset, CRP was undetectable 3. On the other hand, in a case where the last dose was administered 24 days before onset, CRP was detected 5.…”