{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T16:49:36Z","timestamp":1784047776604,"version":"3.55.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Rheumatol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Pleural effusion in systemic lupus erythematous (SLE) is a common symptom, and recent studies demonstrated that IL-6 has a pivotal role in its pathogenesis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report a case of a 15 years old Caucasian boy with a history of persistent pleural effusion without lung involvement or fever. Microbiological and neoplastic aetiologies were previously excluded. Based on the presence of pleuritis, malar rash, reduction of C3 and C4 levels and positivity of antinuclear antibody (ANA) and anti-double stranded DNA (dsDNA), the diagnosis of juvenile SLE (JSLE) was performed. Treatment with high dose of intravenous glucocorticoids and mycophenolate mofetil was started with partial improvement of pleural effusion. Based on this and on adults SLE cases with serositis previously reported, therapy with intravenous tocilizumab (800\u00a0mg every two weeks) was started with prompt recovery of pleural effusion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>To the best of our knowledge, this is the first case of JSLE pleuritis successfully treated with tocilizumab.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12969-021-00635-w","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T11:04:58Z","timestamp":1631790298000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Tocilizumab for massive refractory pleural effusion in an adolescent with systemic lupus erythematosus"],"prefix":"10.1186","volume":"19","author":[{"given":"Arianna","family":"De Matteis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Sacco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Celani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Uva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Messia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Nicolai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Pardeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"De Benedetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Bracaglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,16]]},"reference":[{"key":"635_CR1","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1136\/archdischild-2013-304397","volume":"99","author":"A Midgley","year":"2014","unstructured":"Midgley A, Watson L, Beresford MW. New insights into the pathogenesis and management of lupus in children. Arch Dis Child. 2014;99:563\u20137.","journal-title":"Arch Dis Child"},{"key":"635_CR2","doi-asserted-by":"publisher","first-page":"bcr2016215423","DOI":"10.1136\/bcr-2016-215423","volume":"2016","author":"V Ocampo","year":"2016","unstructured":"Ocampo V, Haaland D, Legault K, Mittoo S, Aitken E. Successful treatment of recurrent pleural and pericardial effusions with tocilizumab in a patient with systemic lupus erythematous. BMJ Case Rep. 2016;2016:bcr2016215423.","journal-title":"BMJ Case Rep"},{"key":"635_CR3","doi-asserted-by":"publisher","first-page":"bcr2012007834","DOI":"10.1136\/bcr-2012-007834","volume":"2012","author":"Y Kamata","year":"2012","unstructured":"Kamata Y, Minota S. Successful treatment of massive intractable pericardial effusion in a patient with systemic lupus erythematosus with tocilizumab. BMJ Case Rep. 2012;2012:bcr2012007834.","journal-title":"BMJ Case Rep"},{"key":"635_CR4","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1136\/annrheumdis-2012-201310","volume":"72","author":"Y Shirota","year":"2013","unstructured":"Shirota Y, Yarboro C, Fischer R, Pham TH, Lipsky P, Illei GG. Impact of anti-interleukin-6 receptor blockade on circulating T and B cell subsets in patients with systemic lupus erythematosus. Ann Rheum Dis. 2013;72:118\u201328.","journal-title":"Ann Rheum Dis"},{"key":"635_CR5","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1002\/art.27221","volume":"62","author":"GG Illei","year":"2010","unstructured":"Illei GG, Shirota Y, Yarboro CH, Daruwalla J, Tackey E, Takada K, et al. Tocilizumab in systemic lupus erythematosus: data on safety, preliminary efficacy, and impact on circulating plasma cells from an open-label phase I dosage-escalation study. Arthritis Rheum. 2010;62:542\u201352.","journal-title":"Arthritis Rheum"},{"key":"635_CR6","doi-asserted-by":"crossref","unstructured":"Choy EH, De Benedetti F, Takeuchi T, Hashizume M, John MR, Kishimoto T. Translating IL-6 biology into effective treatments. Nat Rev Rheumatol. 2020;16:335\u201345.","DOI":"10.1038\/s41584-020-0419-z"},{"key":"635_CR7","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1191\/0961203305lu2187oa","volume":"14","author":"BL Man","year":"2005","unstructured":"Man BL, Mok CC. Serositis related to systemic lupus erythematosus: prevalence and outcome. Lupus. 2005;14:822\u20136.","journal-title":"Lupus"},{"key":"635_CR8","doi-asserted-by":"crossref","unstructured":"Romano C, Del Mastro A, Sellitto A, Solaro E, Esposito S, Cuomo G. Tocilizumab reduces complement C3 and C4 serum levels in rheumatoid arthritis patients. Clin Rheumatol. 2018 Jun;37:1695\u2013700.","DOI":"10.1007\/s10067-018-3992-7"}],"container-title":["Pediatric Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12969-021-00635-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12969-021-00635-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12969-021-00635-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T11:10:59Z","timestamp":1631790659000},"score":1,"resource":{"primary":{"URL":"https:\/\/ped-rheum.biomedcentral.com\/articles\/10.1186\/s12969-021-00635-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,16]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["635"],"URL":"https:\/\/doi.org\/10.1186\/s12969-021-00635-w","relation":{},"ISSN":["1546-0096"],"issn-type":[{"value":"1546-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,16]]},"assertion":[{"value":"24 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval\u00a0and consent to participate"}},{"value":"A written consent form for pubblication of data was obtained by parents.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Dr. De Benedetti has received unrestricted research support paid to his institution from AbbVie, Hoffmann-La Roche, Pfizer, NovImmune, Novartis, Sobi and Sanofi.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"144"}}