{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:29:47Z","timestamp":1786534187105,"version":"build-2736575974"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":223,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Rheumatology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Systemic sclerosis, a rare autoimmune disease in children, frequently presents with aggressive clinical features and high risk of interstitial lung disease. Tocilizumab, an anti\u2013interleukin\u20106 receptor monoclonal antibody, has exhibited efficacy in adult systemic sclerosis with interstitial lung disease; however, evidence in pediatric cases remains extremely limited. We report a 12\u2010year\u2010old Japanese girl who developed early\u2010stage juvenile systemic sclerosis with interstitial lung disease, presenting with Raynaud\u2019s phenomenon, puffy fingers, positive anti\u2013topoisomerase I antibody, reduced pulmonary function, and ground\u2010glass opacities on high\u2010resolution computed tomography. Consequently, tocilizumab monotherapy was initiated. During a follow\u2010up period of over 3\u2009years, her pulmonary function remained stable, and high\u2010resolution computed tomography showed partial resolution of interstitial changes. No significant adverse events, such as severe infections or cytopenias, were observed. Early tocilizumab initiation may represent a potential therapeutic option for juvenile systemic sclerosis with interstitial lung disease. However, further studies are warranted to validate its role and optimize treatment guidelines for this rare but severe condition.<\/jats:p>","DOI":"10.1155\/crrh\/2914024","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T10:35:51Z","timestamp":1786530951000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First\u2010Line Tocilizumab Monotherapy for Juvenile Systemic Sclerosis With Interstitial Lung Disease: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7767-3698","authenticated-orcid":false,"given":"Tadafumi","family":"Yokoyama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5622-0473","authenticated-orcid":false,"given":"Natsumi","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1617-086X","authenticated-orcid":false,"given":"Takashi","family":"Matsushita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6146-6379","authenticated-orcid":false,"given":"Taizo","family":"Wada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-2600(19)30480-1"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.2147\/iprp.s399518"},{"key":"e_1_2_12_3_2","first-page":"377","volume-title":"Textbook of Pediatric Rheumatology","author":"Petty R. 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