case_images: PMC5574418_01
case_images: Patients' markers of disease activity and treatment. CRP (mg/L), dose of GC (mg per day) and PGA (0 to 10). AZT, azathioprine; CRP, C reactive protein; CYC, cyclophosphamide; GC, glucocorticoids; IGIV, intravenous immunoglobulin; MTX, methotrexate; PGA, physician global assessment; TCZ, tocilizumab.
case_images: rmdopen-2017-000446f01.jpg
case_images: PMC5574418_03_rmdopen-2017-000446f01.jpg
case_images: F1
case_images: The condition continued to improve despite the reduction of prednisolone from 60 to 30 mg over the following 3 months (figure 1c).
case_images: PMC5574418_02
case_images: Patients' markers of disease activity and treatment. CRP (mg/L), dose of GC (mg per day) and PGA (0 to 10). AZT, azathioprine; CRP, C reactive protein; CYC, cyclophosphamide; GC, glucocorticoids; IGIV, intravenous immunoglobulin; MTX, methotrexate; PGA, physician global assessment; TCZ, tocilizumab.
case_images: rmdopen-2017-000446f01.jpg
case_images: PMC5574418_03_rmdopen-2017-000446f01.jpg
case_images: F1
case_images: The condition continued to improve despite the reduction of prednisolone from 60 to 30 mg over the following 3 months (figure 1c).
case_images: PMC5574418_03
case_images: Patients' markers of disease activity and treatment. CRP (mg/L), dose of GC (mg per day) and PGA (0 to 10). AZT, azathioprine; CRP, C reactive protein; CYC, cyclophosphamide; GC, glucocorticoids; IGIV, intravenous immunoglobulin; MTX, methotrexate; PGA, physician global assessment; TCZ, tocilizumab.
case_images: rmdopen-2017-000446f01.jpg
case_images: PMC5574418_03_rmdopen-2017-000446f01.jpg
case_images: F1
case_images: The condition continued to improve despite the reduction of prednisolone from 60 to 30 mg over the following 3 months (figure 1c).
case_images: FDG-PET/CT of the third patient before treatment and 4 months later. FDG-PET, 18 F-fluorodeoxyglucose positron emission tomography.
case_images: rmdopen-2017-000446f02.jpg
case_images: PMC5574418_03_rmdopen-2017-000446f02.jpg
case_images: F2
case_images: He was initially successfully treated with prednisolone (80 mg/day) but reported a relapse when prednisolone was reduced to around 40 mg/day. 18 F-fluorodeoxyglucose positron emission combined with CT (FDG-PET/CT) revealed increased FDG uptake in the bone marrow and multiple subcutaneous and intramuscular nodules (maximum standardised uptake value at 5.6) (figure 2). The FDG-PET/CT, conducted 4 months after the beginning of TCZ, was normal (figure 2). Ten months after starting treatment, the patient no longer requires corticosteroids.