Tocilizumab reduces the unmanageable inflammatory reaction of a patient with Aicardi-Goutières syndrome type 7 during treatment with ruxolitinib
Abstract Background Aicardi-Goutières syndrome (AGS) is a rare hereditary early-onset encephalopathy characterized by upregulation of the type I interferon pathway, poorly responsive to conventional immunosuppression. Case presentation We describe a 7-year-old Chinese boy who developed symptoms at...
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2023-10-01T00:00:00Z.
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| 001 | doaj_9d596b9ca1174adf9f97c4ad4cb235dc | ||
| 042 | |a dc | ||
| 100 | 1 | 0 | |a Wei Wang |e author |
| 700 | 1 | 0 | |a Wei Wang |e author |
| 700 | 1 | 0 | |a Siming Peng |e author |
| 700 | 1 | 0 | |a Sihao Gao |e author |
| 700 | 1 | 0 | |a Meiying Quan |e author |
| 700 | 1 | 0 | |a Lijuan Gou |e author |
| 700 | 1 | 0 | |a Changyan Wang |e author |
| 700 | 1 | 0 | |a Zhixing Sun |e author |
| 700 | 1 | 0 | |a Zhuo Li |e author |
| 700 | 1 | 0 | |a Dongmei Lian |e author |
| 700 | 1 | 0 | |a Hongmei Song |e author |
| 245 | 0 | 0 | |a Tocilizumab reduces the unmanageable inflammatory reaction of a patient with Aicardi-Goutières syndrome type 7 during treatment with ruxolitinib |
| 260 | |b BMC, |c 2023-10-01T00:00:00Z. | ||
| 500 | |a 10.1186/s12969-023-00899-4 | ||
| 500 | |a 1546-0096 | ||
| 520 | |a Abstract Background Aicardi-Goutières syndrome (AGS) is a rare hereditary early-onset encephalopathy characterized by upregulation of the type I interferon pathway, poorly responsive to conventional immunosuppression. Case presentation We describe a 7-year-old Chinese boy who developed symptoms at the age of 6 months. He presented with a chilblain-like rash, leukopenia, neutropenia, elevated liver enzymesgrowth retardation, microcephaly, elevated acute phase reactants, intracranial calcification and leukodystrophy. At the age of 3 years old, whole-exome sequencing confirmed a de novo heterozygous gain-of-function mutation, c.1016 C > A (p.Ala339Asp), in the IFIH1 gene, and he was diagnosed with AGS7. He was treated with ruxolitinib accompanied by steroids and thalidomide for about four years. The rash, hematological manifestations, and the liver function were all improved, but the erythrocyte sedimentation rate remained consistently elevated until the addition of tocilizumab, a monoclonal antibody against interleukin 6. Conclusions Ruxolitinib was not successful in suppressing the inflammatory process, and tocilizumab produced highly encouraging results in reducing the inflammatory reaction of AGS. The study makes a significant contribution to the literature because we may found a potential alternative therapeutic option for AGS. | ||
| 546 | |a EN | ||
| 690 | |a Aicardi-Goutières syndrome | ||
| 690 | |a Treatment | ||
| 690 | |a Pediatrics | ||
| 690 | |a RJ1-570 | ||
| 690 | |a Diseases of the musculoskeletal system | ||
| 690 | |a RC925-935 | ||
| 655 | 7 | |a article |2 local | |
| 786 | 0 | |n Pediatric Rheumatology Online Journal, Vol 21, Iss 1, Pp 1-6 (2023) | |
| 787 | 0 | |n https://doi.org/10.1186/s12969-023-00899-4 | |
| 787 | 0 | |n https://doaj.org/toc/1546-0096 | |
| 856 | 4 | 1 | |u https://doaj.org/article/9d596b9ca1174adf9f97c4ad4cb235dc |z Connect to this object online. |