Sustained Tocilizumab and Adjunctive HydroBox Therapy in Refractory Takayasu Arteritis: An 11-year Case Report.
Chen-Yu Liao, Jeng-Wei Lu, Yi-Jung Ho et al.
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Case in brief
A woman with Takayasu arteritis diagnosed at age 13 presented at 25 with sudden vision loss, dizziness, and pulseless upper extremities. Her disease involved multiple great vessels and was complicated by cerebral infarctions and recurrent in-stent restenosis despite IL-6 blockade. Over 11 years, she received more than 50 courses of tocilizumab and multiple angioplasty and stenting procedures; HydroBox therapy was later added. During follow-up, she remained clinically stable, with inflammatory markers suppressed and favorable cerebrovascular findings on serial imaging.
What made this case unusual
The report describes an 11-year course of refractory, extensive-vessel disease with recurrent restenosis and prior cerebral ischemia, managed with sustained tocilizumab and adjunctive HydroBox therapy.
Diagnostic / clinical pearl
In Takayasu arteritis, ongoing IL-6 blockade may not prevent recurrent in-stent restenosis; this case underscores the need to assess both clinical status and vascular findings over time.
Why it matters
The reported stability during combined therapy supports further prospective study of HydroBox as an adjunct, but this single case cannot establish its efficacy.