{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:16:30Z","timestamp":1791828990759,"version":"4.3.4"},"reference-count":15,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,12,1]]},"abstract":"<jats:p>Takayasu arteritis (TA) in the child remains a therapeutic challenge because corticosteroids and conventional immunosuppressive agents are not always safe or efficacious. The complex formed by interleukin-6 (IL-6) and soluble IL-6 receptor appears to play a pivotal role in the pathogenesis of TA. We describe a favorable response to the anti-IL-6 receptor antibody tocilizumab (TCZ) in a child with aggressive and refractory TA including an assessment of the proinflammatory cytokine profile. A 3-year-old girl with TA consisting of thickening of the aortic arch wall, severe obstruction of the supra-aortic branches, and complete occlusion of both common carotid arteries failed to respond to corticosteroids, methotrexate, tumor necrosis factor \u03b1 blockade, cyclophosphamide, and mycophenolate mofetil, and 3 years later, the disease remained active with severe manifestations (brain ischemia). The patient underwent percutaneous angioplasty, although significant restenosis was soon documented. After a severe relapse, the patient started TCZ infusions (8 mg\/kg for 2 weeks), and a rapid clinical remission was observed, associated with a drastic reduction of inflammatory markers and IL-6 levels. Corticosteroids were withdrawn, the patient\u2019s weight and height improved, and bone mineral density values returned to normal. Two years later, TCZ infusions were extended, with no significant side effects. Cerebral ischemia resolved, and recanalization of the previously occluded supra-aortic branches was performed.<\/jats:p>","DOI":"10.1542\/peds.2012-1384","type":"journal-article","created":{"date-parts":[[2012,11,13]],"date-time":"2012-11-13T10:52:14Z","timestamp":1352803934000},"page":"e1720-e1724","source":"Crossref","is-referenced-by-count":38,"title":["Successful Tocilizumab Treatment in a Child With Refractory Takayasu Arteritis"],"prefix":"10.1542","volume":"130","author":[{"given":"Beatriz","family":"Bravo Manche\u00f1o","sequence":"first","affiliation":[{"name":"Pediatric Rheumatology Unit,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Perin","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Pediatrics Department;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda del Mar Rodr\u00ed","family":"guez V\u00e1zquez del Rey","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Pediatrics Department;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Garc\u00eda S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Rheumatology Department; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Pablo","family":"Alc\u00e1zar Romero","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology Unit, Radiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,12,1]]},"reference":[{"issue":"5","key":"2021120823543798200_B1","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1136\/ard.2009.116657","article-title":"EULAR\/PRINTO\/PRES criteria for Henoch-Sch\u00f6nlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria.","volume":"69","author":"Ozen","year":"2010","journal-title":"Ann Rheum Dis"},{"issue":"10","key":"2021120823543798200_B2","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1093\/rheumatology\/keq167","article-title":"Takayasu arteritis in children and adolescents.","volume":"49","author":"Brunner","year":"2010","journal-title":"Rheumatology (Oxford)"},{"issue":"7","key":"2021120823543798200_B3","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1136\/jcp.55.7.481","article-title":"Takayasu arteritis: a review.","volume":"55","author":"Johnston","year":"2002","journal-title":"J Clin Pathol"},{"issue":"4","key":"2021120823543798200_B4","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1093\/rheumatology\/kem379","article-title":"Role of imaging studies in the diagnosis and follow-up of large-vessel vasculitis: an update.","volume":"47","author":"Pipitone","year":"2008","journal-title":"Rheumatology (Oxford)"},{"issue":"4","key":"2021120823543798200_B5","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1002\/art.1780370420","article-title":"Treatment of glucocorticoid-resistant or relapsing Takayasu arteritis with methotrexate.","volume":"37","author":"Hoffman","year":"1994","journal-title":"Arthritis Rheum"},{"issue":"1","key":"2021120823543798200_B6","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jpeds.2006.10.059","article-title":"Takayasu arteritis in children: preliminary experience with cyclophosphamide induction and corticosteroids followed by methotrexate.","volume":"150","author":"Ozen","year":"2007","journal-title":"J Pediatr"},{"issue":"11","key":"2021120823543798200_B7","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1007\/s10067-007-0596-z","article-title":"Mycophenolate mofetil reduces disease activity and steroid dosage in Takayasu arteritis.","volume":"26","author":"Shinjo","year":"2007","journal-title":"Clin Rheumatol"},{"issue":"7","key":"2021120823543798200_B8","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1002\/art.20300","article-title":"Anti-tumor necrosis factor therapy in patients with difficult to treat Takayasu arteritis.","volume":"50","author":"Hoffman","year":"2004","journal-title":"Arthritis Rheum"},{"issue":"11","key":"2021120823543798200_B9","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1136\/ard.2008.093260","article-title":"Anti-tumour necrosis factor therapy in patients with refractory Takayasu arteritis: long-term follow-up.","volume":"67","author":"Molloy","year":"2008","journal-title":"Ann Rheum Dis"},{"issue":"5","key":"2021120823543798200_B10","doi-asserted-by":"crossref","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)"},{"issue":"10","key":"2021120823543798200_B11","doi-asserted-by":"crossref","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"},{"issue":"4","key":"2021120823543798200_B12","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1002\/art.23373","article-title":"Successful treatment of a patient with Takayasu arteritis using a humanized anti-interleukin-6 receptor antibody.","volume":"58","author":"Nishimoto","year":"2008","journal-title":"Arthritis Rheum"},{"key":"2021120823543798200_B13","first-page":"w13156","article-title":"Rapid induction of remission in large vessel vasculitis by IL-6 blockade. A case series.","volume":"141","author":"Seitz","year":"2011","journal-title":"Swiss Med Wkly"},{"issue":"1","key":"2021120823543798200_B14","doi-asserted-by":"crossref","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 (Oxford)"},{"issue":"3","key":"2021120823543798200_B15","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s002709900248","article-title":"Early and long-term results of subclavian angioplasty in aortoarteritis (Takayasu disease): comparison with atherosclerosis.","volume":"21","author":"Tyagi","year":"1998","journal-title":"Cardiovasc Intervent Radiol"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/130\/6\/e1720\/898112\/peds_2012-1384.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/130\/6\/e1720\/898112\/peds_2012-1384.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T05:15:22Z","timestamp":1639026922000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/130\/6\/e1720\/30273\/Successful-Tocilizumab-Treatment-in-a-Child-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12,1]]},"references-count":15,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2012,12,1]]},"published-print":{"date-parts":[[2012,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2012-1384","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12,1]]}}}