Acute intestinal necrosis in a patient receiving tocilizumab: A case report and literature review

In this article, we report a case of acute intestinal necrosis associated with tocilizumab use. A 68-year-old female was admitted to the intensive care unit (ICU) with a history of rash for 20 days and dyspnea for 15 days. She was diagnosed with severe pneumonia with type I respiratory failure, which deteriorated to acute respiratory distress syndrome (ARDS). The possibility of immune-related pneumonia secondary to dermatomyositis was considered. The patient received tocilizumab treatment. Eight days after the second tocilizumab dose, the patient developed fever and abdominal distention and finally died due to acute intestinal compromise. This case may provide insight into the occurrence of acute intestinal necrosis related to tocilizumab administration and can help prevent similar occurrences.