1. Tocilizumab-induced anaphylaxis in two patients with COVID-19-induced cytokine storm.
- Author
-
Atayık, Emel and Aytekin, Gökhan
- Subjects
- *
CYTOKINE release syndrome , *ANAPHYLAXIS , *THERAPEUTICS - Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a zoonotic virus which was first discovered in Wuhan, the People's Republic of China in December 2019 and has led to one of the greatest pandemics of world history in a short period of time 1. SARS-CoV-2 is a rapidly spreading infectious disease with a high mortality rate. The disease has a moderate and severe course in approximately 20% of the patients and mortality reaches up to 62% among these patients 2. The majority of the patients develop SARS-CoV-2-induced pneumonia and manifestations of pneumonia rapidly progress to respiratory failure. In severe Covid pneumonia, it has been demonstrated that increased plasma concentrations of cytokines including interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and IL-12 are involved in immune response and in cytokine storm caused by the increase in these cytokines lead to mortality1, 3. Tocilizumab (TCZ) is a promising agent that is used for the treatment of cytokine storm. TCZ is an IgG1 class recombinant humanized monoclonal antibody against IL-6 receptor 3. It has then been used for the treatment of rheumatic diseases. Due to its mechanism of action, TCZ treatment comes to the forefront particularly in cases of severe COVID-19-induced cytokine pneumonia presenting with cytokine storm 3. However, potential IgE-mediated immunological reactions against this drug, especially anaphylaxis, may deprive these patients of an important treatment option for the treatment of COVID-19-induced cytokine storm. Although TCZ-induced anaphylaxis has been reported as case reports of indicated rheumatic diseases, TCZ-induced anaphylaxis has not yet been reported in patients using TCZ for SARS-CoV-2-induced cytokine storms 4. In this case series, we aimed to represent cases of anaphylaxis which developed in two different patients using TCZ for SARS-CoV-2-induced cytokine storm. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF