トシリズマブ使用中に施行した腹腔鏡下単純子宮全摘出術後に骨盤内膿瘍を生じた一例

抄録

　Tocilizumab (TCZ) is a humanized anti-human IL-6 receptor monoclonal antibody that suppresses the signaling of IL-6, which is important for inflammation and immune activation. In Japan, the use of TCZ for treatment of rheumatoid arthritis (RA), Castleman's disease, juvenile idiopathic arteritis, and Takayasu's arteritis / giant cell arteritis, etc. has been approved. IL-6 inhibition of TCZ suppresses leukocyte infiltration into the inflamed area. In addition, when TCZ achieves an effective blood concentration, C-reactive protein (CRP) becomes negative regardless of clinical presentation. Inflammatory outcomes such as CRP and erythrocyte sedimentation rate may be significantly different from clinical symptoms. We report a case of pelvic abscess following a laparoscopic simple total hysterectomy and bilateral salpingectomy during TCZ administration, along with a review of literature.