Acute Hypertriglyceridaemia Caused by Tocilizumab in a Patient with Severe COVID-19

Hideta Nakamura; Kazuya Miyagi; Mariko Otsuki; Yuuri Higure; Naoya Nishiyama; Takeshi Kinjo; Masashi Nakamatsu; Shusaku Haranaga; Masao Tateyama; Jiro Fujita

doi:10.2169/internalmedicine.5244-20

CASE REPORTS

Acute Hypertriglyceridaemia Caused by Tocilizumab in a Patient with Severe COVID-19

Hideta Nakamura, Kazuya Miyagi, Mariko Otsuki, Yuuri Higure, Naoya Nishiyama, Takeshi Kinjo, Masashi Nakamatsu, Shusaku Haranaga, Masao Tateyama, Jiro Fujita

Author information

Hideta Nakamura
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan
Kazuya Miyagi
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan
Mariko Otsuki
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan
Yuuri Higure
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan
Naoya Nishiyama
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan
Takeshi Kinjo
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan
Masashi Nakamatsu
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan
Shusaku Haranaga
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan
Masao Tateyama
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan
Jiro Fujita
Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Japan

Keywords: COVID-19, tocilizumab, acute hypertriglyceridaemia

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 22 Pages 2945-2949

DOI https://doi.org/10.2169/internalmedicine.5244-20

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Abstract

Treatment with tocilizumab (TCZ) to block interleukin-6 (IL-6) signalling is predicted to mitigate cytokine release syndrome (CRS) caused by coronavirus disease 2019 (COVID-19). However, the adverse effects of TCZ on patients with COVID-19 remain unclear. We herein report a patient with COVID-19 treated with TCZ who developed acute hypertriglyceridaemia. Despite favipiravir treatment, acute respiratory distress syndrome developed in a 45-year-old patient with COVID-19; thus, TCZ was initiated. The triglyceride levels greatly increased after TCZ administration. Physicians should consider the negative impact of TCZ on the lipid profile in patients with COVID-19, although COVID-19-induced CRS itself may be an aggravating factor.

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