Abstract
We experienced two cases with rheumatoid arthritis which were diagnosed as pneumonia during tocilizumab treatment. Both cases showed clear symptoms such as general fatigue (case 1), coughing, and sputum (case 2). One patient (case 1) had an increased fever, but the other (case 2) did not. C-reactive protein showed negative on admission probably because of the effect of tocilizumab. However, white blood cells and the proportion of neutrophils were highly upregulated compared with those before the onset of pneumonia, suggesting that these findings were helpful for the diagnosis of bacterial pneumonia. Both cases showed a flare-up of disease activity and one (case 1) was treated with tocilizumab again while the other (case 2) was switched to etanercept.
