rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2019-482-485rsp-2764Research ArticleКЛИНИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL OBSERVATIONSЛекарственная энцефалопатия с нарушением когнитивных функций на фоне применения тоцилизумабаDRUG-INDUCED ENCEPHALOPATHY WITH IMPAIRED COGNITIVE FUNCTIONS DURING TOCILIZUMAB USEШестерняП. А.ShesternyaP. A.

660022, Красноярск, ул. Партизана Железняка, 1

1, Partisan Zheleznyak St., Krasnoyarsk 660022

shesternya75@mail.ruПрокопенкоС. В.ProkopenkoS. V.

660022, Красноярск, ул. Партизана Железняка, 1

1, Partisan Zheleznyak St., Krasnoyarsk 660022

МожейкоЕ. Ю.MozheikoE. Yu.

660022, Красноярск, ул. Партизана Железняка, 1

1, Partisan Zheleznyak St., Krasnoyarsk 660022

ГриценкоО. Д.GritsenkoO. D.

660022, Красноярск, ул. Партизана Железняка, 1

1, Partisan Zheleznyak St., Krasnoyarsk 660022

ТупаеваТ. В.TupaevaT. V.

660022, Красноярск, ул. Партизана Железняка, 1

1, Partisan Zheleznyak St., Krasnoyarsk 660022

КурцЕ. М.KurtsE. M.

660022, Красноярск, ул. Партизана Железняка, 1

1, Partisan Zheleznyak St., Krasnoyarsk 660022

ФГБОУ ВО «Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого»РоссияProf. V.F. Voino-Yasenetsky Krasnoyarsk State Medical UniversityRussian Federation201916092019574482485Copyright © Шестерня П.А., Прокопенко С.В., Можейко Е.Ю., Гриценко О.Д., Тупаева Т.В., Курц Е.М., 20192019Шестерня П.А., Прокопенко С.В., Можейко Е.Ю., Гриценко О.Д., Тупаева Т.В., Курц Е.М.Shesternya P.A., Prokopenko S.V., Mozheiko E.Y., Gritsenko O.D., Tupaeva T.V., Kurts E.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2764

Блокада интерлейкина 6 (ИЛ6) является одним из наиболее перспективных направлений в лечении целого ряда иммуновоспалительных заболеваний. Тоцилизумаб (ТЦЗ) – первое зарегистрированное моноклональное антитело к рецептору ИЛ6 – эффективно используется ревматологами с 2010 г. За этот период спектр неблагоприятных реакций (НР) ТЦЗ определен достаточно четко. Однако многогранность биологических эффектов ИЛ6 предопределяет вероятность развития непредвиденных НР. В статье приведен клинический случай лекарственной энцефалопатии с когнитивной дисфункцией на фоне лечения ТЦЗ.

Blockade of interleukin-6 (IL-6) is one of the most promising areas in the treatment of a number of immunoinflammatory diseases. Tocilizumab (TCZ), the first registered anti-IL-6 receptor monoclonal antibody, has been used effectively by rheumatologists since 2010. During this period, the spectrum of adverse reactions (ARs) of TCZ has been clearly defined. However, the multifaceted biological effects of IL-6 determine the probability of unexpected ARs. The article describes a clinical case of drug-induced encephalopathy with cognitive dysfunction during TCZ therapy.

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Biokhimiya = Biochemisry. 2017;82(3):397-409 (In Russ.). doi: 10.1134/S000629791703004XLevin SG, Godukhin OV. Modulating effect of cytokines on mechanisms of synaptic plasticity in the brain. Biokhimiya = Biochemisry. 2017;82(3):397-409 (In Russ.). doi: 10.1134/S000629791703004XPranzatelli MR. Advances in biomarker-guided therapy for pediatric- and adult-onset neuroinflammatory disorders: targeting chemokines/cytokines. Front Immunol. 2018 Apr;4(9):557. doi: 10.3389/fimmu.2018.00557Pranzatelli MR. Advances in biomarker-guided therapy for pediatric- and adult-onset neuroinflammatory disorders: targeting chemokines/cytokines. Front Immunol. 2018 Apr;4(9):557. doi: 10.3389/fimmu.2018.00557Pranzatelli MR. Advances in biomarker-guided therapy for pediatric- and adult-onset neuroinflammatory disorders: targeting chemokines/cytokines. Front Immunol. 2018 Apr;4(9):557. doi: 10.3389/fimmu.2018.00557Pranzatelli MR. 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Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2013;51(2):98-103 (In Russ.)]. doi: 10.14412/1995-4484-2013-634Lisitsyna TA, Veltishchev DYu, Nasonov EL. Stressors and depressive disorders in rheumatic diseases. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2013;51(2):98-103 (In Russ.)]. doi: 10.14412/1995-4484-2013-634Lisitsyna TA, Veltishchev DYu, Nasonov EL. Stressors and depressive disorders in rheumatic diseases. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2013;51(2):98-103 (In Russ.)]. doi: 10.14412/1995-4484-2013-634Yoon B, Lee JH, Shin SY. Discrepancy between subjective and objective measures of cognitive impairment in patients with rheumatoid arthritis. Rheumatol Int. 2017;37(10):1635-41. doi: 10.1007/s00296-017-3806-2Yoon B, Lee JH, Shin SY. Discrepancy between subjective and objective measures of cognitive impairment in patients with rheumatoid arthritis. 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The authors declare that there are no conflicts of interest present.