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NDT Plus Advance Access published online on October 8, 2008
NDT Plus, doi:10.1093/ndtplus/sfn157
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Interleukin-6 receptor inhibition with tocilizumab in various renal involvements associated with multicentric Castleman's disease: a report of three cases

Hirotaka Komaba1, Takashi Nakazawa2, Yutaka Yamaguchi3, Shunichi Kumagai2 and Masafumi Fukagawa1

1 Division of Nephrology and Kidney Center
2 Department of Clinical Pathology and Immunology, Kobe University School of Medicine, Kobe
3 Department of Pathology, Kashiwa Hospital, The Jikei University School of Medicine, Chiba, Japan

Correspondence: Correspondence and offprint requests to: Masafumi Fukagawa, Division of Nephrology and Kidney Center, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. Tel: +81-78-382-6500; Fax: +81-78-382-6509; E-mail: fukagawa{at}med.kobe-u.ac.jp


  Abstract

Multicentric Castleman's disease (MCD) is an inflammatory lymphoproliferative disorder characterized by polyclonal hypergammopathy and dysregulated overproduction of interleukin-6 (IL-6). A variety of renal involvements infrequently arise in patients with MCD. However, there is no established treatment for MCD and its associated renal involvements. We present the effects of an anti-IL-6 receptor monoclonal antibody, tocilizumab, on three patients with MCD associated with various renal manifestations. In all three patients, tocilizumab treatment was very effective in reducing proteinuria and stabilizing renal function, as well as improving other clinical symptoms. These findings indicate the pathological significance of IL-6 in renal involvements associated with MCD, and the potential use of tocilizumab in its treatment.

Key Words: anti-interleukin-6 receptor antibody • interleukin-6 • multicentric Castleman’s disease • tocilizumab

Received for publication September 13, 2008. Accepted for publication September 16, 2008.


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