RT Journal Article
SR Electronic
T1 C reactive protein may not be reliable as a marker of severe bacterial infection in patients receiving tocilizumab
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr2013010423
DO 10.1136/bcr-2013-010423
VO 2013
A1 Bari, Syed Farhan
A1 Khan, Afsha
A1 Lawson, Tom
YR 2013
UL http://casereports.bmj.com/content/2013/bcr-2013-010423.abstract
AB This is a case of a 65-year-old man with seropositive erosive rheumatoid arthritis (RA), well controlled on methotrexate, sulfasalazine, low-dose prednisolone and monthly infusions of tocilizumab. He presented with a 3-week history of pain and swelling in his left knee, gradually increasing in severity with an inability to bear weight . He was systemically well with normal vital signs. Examination confirmed an effusion and aspiration was turbid in appearance. C reactive protein (CRP) was normal. He was treated empirically with antibiotics. Synovial fluid and blood cultures confirmed Staphylococcus aureus infection. He completed a 6 weeks course of antibiotics with complete resolution of symptoms. Throughout the treatment his CRP remained normal which is likely to have been the result of prior treatment with tocilizumab.