Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports

Authors

• Guiomar Pinheiro Internal Medicine Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
• Ana Rita Costa Internal Medicine Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
• Ana Campar Department of Clinical Immunology, Centro Hospitalar Universitário do Porto, Porto, Portugal
• Teresa Mendonça Internal Medicine Department, Centro Hospitalar Universitário do Porto, Porto, Portugal

mguiomarpinheiro@gmail.com

Keywords

Abstract

Fasciitis with eosinophilia (FE) is a rare connective tissue disease. Due to its rarity, large-scale studies are lacking, which makes its treatment challenging. Systemic corticosteroids (SCSs) are the cornerstone of treatment; however, additional immunosuppressive drugs (ISDs) are frequently necessary (usually methotrexate). We report 2 patients, for whom an SCS and methotrexate were not a viable long-term option. In the first case, we were unable to taper the SCS dose without symptom relapse, the patient showed only a partial response to methotrexate and presented side effects. The second case never fully responded to the SCS and methotrexate and demonstrated serious SCS adverse effects. Both patients were started on tocilizumab with extremely favourable results, making this drug a potential therapeutic weapon for these patients.