PMC8655874_01
Serum creatine (blue line) and diuresis (red line) before and after tocilizumab administration in the described patient. A: Serum creatinine and diuresis at time of 50% cyclosporine dose reduction. B: Serum creatinine and diuresis at time of withdrawn cyclosporine administration. C: Serum creatinine and diuresis after 24-48 h of tocilizumab administration.
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F1
C-reactive protein was consistently declined to 1.6 mg/l with improvement of graft function (Figure 1). After 4 days from tocilizumab administration, physical examination revealed an improvement of the respiratory clinic with a stable oxygen saturation on the ventilator around 99%, respiratory rate of 29 breaths/min, and serum creatinine returned to baseline level (1.02 mg/ml) (Figure 1); a second X-ray was performed showing a reduction of the pulmonary opacities (Figure 2A, X-ray at hospital admission; Figure 2B, X-ray after tocilizumab administration).
(A) X-ray at hospital admission describing parenchymal thickening and a bilateral widespread pulmonary interstitial involvement. (B) Tocilizumab administration led to bilateral improvement with a decrease in the density and in the extension of lung thicknesses (X-ray).
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F2
After 4 days from tocilizumab administration, physical examination revealed an improvement of the respiratory clinic with a stable oxygen saturation on the ventilator around 99%, respiratory rate of 29 breaths/min, and serum creatinine returned to baseline level (1.02 mg/ml) (Figure 1); a second X-ray was performed showing a reduction of the pulmonary opacities (Figure 2A, X-ray at hospital admission; Figure 2B, X-ray after tocilizumab administration).