Stevens Johnson Syndrome in a Patient with Giant Cell Arteritis During Short Term Tocilizumab Therapy

This case report represents a rare life-threatening hypersensitivity reaction of tocilizumab drug when it is used to treat giant cell arteritis. An elderly female with history of bilateral giant cell arteritis with anterior ischemic optic neuropathy of the right eye was started on tocilizumab after developing glucocorticoid-related complications. She received one month of the tocilizumab therapy along with the prednisone taper. The patient initially developed sinus and mucosal edema, presented as drooling with mild tongue and lip swelling. It eventually progressed into development of new onset of erythematous macules and flaccid bullae which was biopsy-confirmed Stevens Johnson syndrome. Tocilizumab drug was immediately discontinued and she was treated with supportive care. The goal of this report is to present the first detailed case of presumed tocilizumab-induced Steven Johnson syndrome which emphasizes the importance of post-marketing surveillance and collection of data on adverse events of this drug.