• Internal medicine · Dec 2021

    Case Reports

    Aseptic Meningitis-retention Syndrome Associated with Tocilizumab in a Patient with Idiopathic Multicentric Castleman Disease.

    • Akira Arakawa, Masaki Iizuka, Shunichi Matsuda, Erika Matsubara, Hiroki Yamazaki, Noritada Yoshikawa, Hirotoshi Tanaka, and Toshihiro Yoshizawa.
    • Department of Neurology, NTT Medical Center Tokyo, Japan.
    • Intern. Med. 2021 Dec 15; 60 (24): 3995-3998.

    AbstractThis is the first report of tocilizumab-associated meningitis-retention syndrome in a patient with idiopathic multicentric Castleman disease. A 57-year-old man presented with headache, nuchal rigidity, impaired consciousness, pyramidal tract signs and urinary retention. A cerebrospinal fluid examination revealed increased cell counts and protein levels. These symptoms were improved by intravenous methylprednisolone. Tocilizumab-associated meningoencephalitis has been reported in patients with rheumatoid arthritis and juvenile idiopathic arthritis but not with multicentric Castleman disease. This case presents evidence of the increased probability of meningitis as a neurological complication of tocilizumab administration.

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