Uso de Tocilizumab en Artritis Reumatoide Juvenil de Difícil manejo

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disorder that can affect more than just the joints. An autoimmune disorder, rheumatoid arthritis occurs when immune system mistakenly attacks the body's tissues. It causes a severe and permanent incapacity, moreover early mortality. About 1-2 % people have rheumatoid arthritis (RA). Mainly in female sex, without clear predominance in ethnic groups.

Patient is 20 years old with foregoing rheumatoid arthritis diagnosed 4 years ago in irregular treatment with prednisone, NSAIDs and methotrexate, as familiar antecedent referred uterus cancer, she was an external consultation in internal medicine, due to pain in the knee joints of long evolution. Which hindered ambulation, with the apparent cause failure of treatment of underlying disease, she said that four months before the current hospitalization had been administered a dose of infliximab, she was hospitalized in Ambato Hospital of IESS in order to better control of the disease. During the physical exam of entrance she was conscious, awake, oriented, afebrile, hydrated, sore; in her knees had a warm edema which kept fovea and bilateral flush, tenderness and pain with the movements. She was sent to performing laboratory tests in which PCR 24 , latex 512, VSG 19 , ASTO 200 was found , infectious EMO, during hospitalization doctors made her artroscentesis diagnostic and therapeutic knee results whose found 11.7 lymphocytes , monocytes 7.8 , glucose 0.18 , 890 LDH , total protein found 4.3. By exacerbations of the disease and lack of discipline on the part of the patient, doctor decides to start treatment with tocilizumab for which are performed several hospitalizations for the administration of this biologic drug.