case_images: PMC6129367_01
case_images: (a) Change in clinical disease activity inflammatory markers in response tocilizumab. Note. PGA: physician global assessment, 0-10, 0 indicating absence of disease activity and 10 indicating severe disease. ESR: erythrocyte sedimentation rate. CRP: C reactive protein. PGA fell from 8/10 immediately before the first tocilizumab infusion to 1/10 when assessed immediately prior to the next infusion 2 weeks later. This excellent clinical and serological response has been sustained for 24 months. (b) Change in haemoglobin, total white cell count, and platelet count in response to tocilizumab. Black arrow shows date of first dose of tocilizumab.
case_images: CRIPE2018-3514645.001.jpg
case_images: PMC6129367_01_CRIPE2018-3514645.001.jpg
case_images: fig1
case_images: After one dose of tocilizumab, her CRP and ESR both rapidly normalised (Figure 1(a)). Since normalisation of CRP is a well-known effect of tocilizumab and may occur without necessarily any true improvement in clinical disease activity, we also prospectively used a physician global assessment of disease activity using a 0 to 10 scale, 0 indicating no disease activity and 10 indicating severe disease activity (Figure 1(a)), and change in haemoglobin, white cell count, and platelets (Figure 1(b)) as adjunctive laboratory indicators of successful treatment.