Is Tocilizumab A Risk Factor for Lower Gastrointestinal Perforations? Isolated Cecal Necrosis: A Rare Case Report
Journal Title: Turkish Journal of Colorectal Disease - Year 2020, Vol 30, Issue 1
Abstract
Isolated cecal necrosis is a rare seen clinical condition. A 53-year-old woman with a history of rheumatoid arthritis and hypertension presented to the emergency room with complaints of abdominal pain and vomiting that persists for two days. She had been using tocilizumab (TCZ) for the last 5 months. Physical examination was compatible with acute abdomen. Abdomen computerized tomography showed a wall thickness approximately 3 cm on ascending colon that surrounded with significant inflammation. She was operated with a presumptive diagnosis of acute abdomen. During laparotomy, isolated necrosis with 10x9 cm diameter was observed in the cecum. A right hemicolectomy and ileocolostomy was performed. She was discharged on the 8th postoperative day. Postoperative specimen pathology was showed mucosal necrosis sharply separated from normal mucosal walls. Although the side effect profile of newly used drugs such as TCZ is not clear yet; with larger case reports and series can be contributed.
Authors and Affiliations
Emran Kuzey Avcı, Semra Demirli Atıcı, Sümeyye Ekmekçi, Can Arıcan, Tayfun Kaya, Cem Tuğmen
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