Immunsuppression kan maskera allvarlig infektion. Septisk artrit under tocilizumabbehandling gav endast blygsam akutfasreaktion
Sammanfattning
In this case report we want to draw attention to the risk of a weakened acute-phase response during treatment with tocilizumab. The patient is a 50-year-old man with long-standing rheumatoid arthritis, who had been treated with tocilizumab for six months when he suffered a septic arthritis in his right elbow joint. Throughout the course of the infection fever and malaise were absent and the concentration of C-reactive protein increased only slightly. This report stresses the importance of taking into account the patient’s medication and immunological status in the assessment. If a severe infection is suspected during treatment with the ability to affect the acute-phase response, it is important to pursue with the diagnostic procedures and to treat on wide indications while waiting for results of bacterial cultures.