{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T03:14:41Z","timestamp":1771298081421,"version":"3.50.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T00:00:00Z","timestamp":1661472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Takayasu arteritis (TAK) is classified as large vessel vasculitis, and continuous inflammation of the vessel results in aneurysm or stenosis, which leads to various serious complications. Recently, a TAKT [TAK treated with tocilizumab (TCZ)] study showed that subcutaneous TCZ, a humanised anti-interleukin-6 receptor monoclonal antibody, is an effective treatment in patients with TAK above 12\u2009years of age; however, the effectiveness of TCZ for juvenile TAK under 12\u2009years old remains unclear. Here, we described the case of a 2-year-old girl with TAK, which was successfully treated with intravenous TCZ. She was diagnosed with TAK type V (Numano\u2019s angiographic classification system) with aortic aneurysms, bilateral renal arteries stenosis, and atypical descending aortic coarctation based on contrast-enhanced computed tomography findings. Treatment was started with 2\u2009mg\/kg\/day prednisolone (PSL) and methotrexate instead of methylprednisolone pulse due to renovascular hypertension. She was immediately afebrile and her C-reactive protein level decreased, although it was elevated 4\u2009weeks after starting PSL. Intravenous TCZ of 8\u2009mg\/kg\/2\u2009weeks was added because the progression of aneurysms or stenosis might lead to a poor prognosis. PSL was steadily reduced under intravenous TCZ. Magnetic resonance imaging showed that aortic aneurysms, renal arteries stenosis, and aortic coarctation ameliorated 4\u2009months after starting TCZ, with the amelioration maintained at 1\u2009year after starting TCZ. Aneurysms and stenosis improved; therefore, TCZ may be effective for the treatment of inflammation of vessels, aneurysms, and stenosis. It is desirable to examine the effect of TCZ on TAK patients under 12\u2009years of age.<\/jats:p>","DOI":"10.1093\/mrcr\/rxac068","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T13:27:17Z","timestamp":1661520437000},"page":"160-165","source":"Crossref","is-referenced-by-count":3,"title":["Intravenous tocilizumab for Takayasu arteritis with aortic aneurysms, bilateral renal artery stenosis, and atypical aortic coarctation in a 2-year-old girl"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6440-9110","authenticated-orcid":false,"given":"Yuji","family":"Fujita","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minako","family":"Tomiita","sequence":"additional","affiliation":[{"name":"Department of Allergy and Rheumatology, Chiba Children\u2019s Hospital , Chiba, Japan"},{"name":"Department of Pediatrics, Pediatric Allergy and Rheumatology Center, NHO Shimoshizu National Hospital , Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayumi","family":"Saida","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Omura","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megumi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuto","family":"Otsubo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhi","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Kano","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaori","family":"Sekine","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keitaro","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeko","family":"Kuwashima","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigemi","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dokkyo Medical University , Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"2023010315534841100_R1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/art.37715","article-title":"2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides","volume":"65","author":"Jennette","year":"2013","journal-title":"Arthritis Rheum"},{"key":"2023010315534841100_R2","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1253\/circj.CJ-19-0773","article-title":"JSC 2017 guideline on management of vasculitis syndrome - digest version","volume":"84","author":"Isobe","year":"2020","journal-title":"Circ J"},{"key":"2023010315534841100_R3","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1002\/art.1780330811","article-title":"The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis","volume":"33","author":"Arend","year":"1990","journal-title":"Arthritis Rheum"},{"key":"2023010315534841100_R4","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1002\/art.22404","article-title":"Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients","volume":"56","author":"Maksimowicz-mckinnon","year":"2007","journal-title":"Arthritis Rheum"},{"key":"2023010315534841100_R5","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1136\/annrheumdis-2017-211878","article-title":"Efficacy and safety of tocilizumab in patients with refractory Takayasu arteritis: results from a randomised, double-blind, placebo-controlled, phase 3 trial in Japan (the TAKT study)","volume":"77","author":"Nakaoka","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"2023010315534841100_R6","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jaut.2018.04.002","article-title":"Efficacy of tocilizumab in Takayasu arteritis: multicenter retrospective study of 46 patients","volume":"91","author":"Mekinian","year":"2018","journal-title":"J Autoimmun"},{"key":"2023010315534841100_R7","doi-asserted-by":"publisher","first-page":"1617","DOI":"10.1093\/rheumatology\/kez511","article-title":"Tocilizumab monotherapy for large vessel vasculitis: results of 104-week treatment of a prospective, single-centre, open study","volume":"59","author":"Saito","year":"2020","journal-title":"Rheumatology (Oxford)"},{"key":"2023010315534841100_R8","doi-asserted-by":"publisher","first-page":"279","DOI":"10.5761\/atcs.ra.18-00136","article-title":"Aortitis presenting as fever of unknown origin","volume":"24","author":"Yuan","year":"2018","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"2023010315534841100_R9","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-018-1790-x","article-title":"Clinical course and prognostic factors of childhood Takayasu\u2019s arteritis: over 15-year comprehensive analysis of 101 patients","volume":"21","author":"Fan","year":"2019","journal-title":"Arthritis Res Ther"},{"key":"2023010315534841100_R10","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/j.jvs.2005.01.022","article-title":"Surgical treatment of atypical aortic coarctation complicating Takayasu\u2019s arteritis -- experience with 33 cases over 44 years","volume":"41","author":"Taketani","year":"2005","journal-title":"J Vasc Surg"},{"key":"2023010315534841100_R11","doi-asserted-by":"publisher","first-page":"1788","DOI":"10.1161\/01.CIR.93.10.1788","article-title":"Restricted usage of T-cell receptor Valpha-Vbeta genes in infiltrating cells in aortic tissue of patients with Takayasu\u2019s arteritis","volume":"93","author":"Seko","year":"1996","journal-title":"Circulation"},{"key":"2023010315534841100_R12","first-page":"S21","article-title":"The critical role of IL-6 in the pathogenesis of Takayasu arteritis","volume":"34","author":"Kong","year":"2016","journal-title":"Clin Exp Rheumatol"},{"key":"2023010315534841100_R13","first-page":"62","article-title":"Pro-fibrotic effect of IL-6 via aortic adventitial fibroblasts indicates IL-6 as a treatment target in Takayasu arteritis","volume":"36","author":"Kong","year":"2018","journal-title":"Clin Exp Rheumatol"},{"key":"2023010315534841100_R14","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1093\/rheumatology\/kei266","article-title":"Serum cytokine profiles and their correlations with disease activity in Takayasu\u2019s arteritis","volume":"45","author":"Park","year":"2006","journal-title":"Rheumatology (Oxford)"},{"key":"2023010315534841100_R15","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1093\/rheumatology\/ker296","article-title":"Tocilizumab: a novel therapy for patients with large-vessel vasculitis","volume":"51","author":"Salvarani","year":"2012","journal-title":"Rheumatology (Oxfodr)"},{"key":"2023010315534841100_R16","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1080\/24725625.2018.1479155","article-title":"Successful treatment with tocilizumab monotherapy for Takayasu arteritis developing during infliximab therapy in a patient with ulcerative colitis","volume":"2","author":"Shibata","year":"2018","journal-title":"Mod Rheumatol Case Rep"},{"key":"2023010315534841100_R17","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000018890","article-title":"Effectiveness of tocilizumab in juvenile patients with refractory Takayasu arteritis: two case reports","volume":"99","author":"Asano","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"2023010315534841100_R18","doi-asserted-by":"publisher","first-page":"2369","DOI":"10.1007\/s10067-020-05005-7","article-title":"Tocilizumab treatment effectively improves coronary artery involvement in patients with Takayasu arteritis","volume":"39","author":"Pan","year":"2020","journal-title":"Clin Rheumatol"},{"key":"2023010315534841100_R19","doi-asserted-by":"publisher","first-page":"2360","DOI":"10.1093\/rheumatology\/keab684","article-title":"Vascular imaging of patients with refractory Takayasu arteritis treated with tocilizumab: post hoc analysis of a randomized controlled trial","volume":"61","author":"Nakaoka","year":"2022","journal-title":"Rheumatology (Oxford)"},{"key":"2023010315534841100_R20","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214642","article-title":"Disease progression of Takayasu arteritis in two patients treated with tocilizumab","volume":"79","author":"Sanchez-Alvarez","year":"2020","journal-title":"Ann Rheum Dis"},{"key":"2023010315534841100_R21","doi-asserted-by":"publisher","first-page":"e1720","DOI":"10.1542\/peds.2012-1384","article-title":"Successful tocilizumab treatment in a child with refractory Takayasu arteritis","volume":"130","author":"Mancheno","year":"2012","journal-title":"Pediatrics"},{"key":"2023010315534841100_R22","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/j.semarthrit.2016.07.012","article-title":"Tocilizumab treatment in childhood Takayasu arteritis: case series of four patients and systematic review of the literature","volume":"46","author":"Batu","year":"2017","journal-title":"Semin Arthritis Rheum"},{"key":"2023010315534841100_R23","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1007\/s00380-021-01981-1","article-title":"Efficacy of tocilizumab for refractory Takayasu arteritis: a retrospective study and literature review","volume":"37","author":"Li","year":"2022","journal-title":"Heart Vessels"},{"key":"2023010315534841100_R24","doi-asserted-by":"publisher","first-page":"2385","DOI":"10.1056\/NEJMoa1112802","article-title":"Randomized trial of tocilizumab in systemic juvenile idiopathic arthritis","volume":"367","author":"De Benedetti","year":"2012","journal-title":"N Engl J Med"},{"key":"2023010315534841100_R25","doi-asserted-by":"publisher","first-page":"506","DOI":"10.3109\/03009741003742730","article-title":"Juvenile-onset Takayasu arteritis: peculiar vascular involvement and more refractory disease","volume":"39","author":"Jales-Neto","year":"2010","journal-title":"Scand J Rheumatol"},{"key":"2023010315534841100_R26","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1093\/rheumatology\/kez245","article-title":"Clinical usefulness of longitudinal IL-6 monitoring in a patient with Takayasu aortitis receiving tocilizumab","volume":"59","author":"Sakumura","year":"2020","journal-title":"Rheumatology (Oxford)"}],"container-title":["Modern Rheumatology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mrcr\/advance-article-pdf\/doi\/10.1093\/mrcr\/rxac068\/45662436\/rxac068.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/7\/1\/160\/48482533\/rxac068.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/7\/1\/160\/48482533\/rxac068.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T15:57:31Z","timestamp":1672761451000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mrcr\/article\/7\/1\/160\/6677184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,26]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,8,26]]},"published-print":{"date-parts":[[2023,1,3]]}},"URL":"https:\/\/doi.org\/10.1093\/mrcr\/rxac068","relation":{},"ISSN":["2472-5625"],"issn-type":[{"value":"2472-5625","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,1,1]]},"published":{"date-parts":[[2022,8,26]]}}}