Onset of suspected ulcerative colitis after treatment with tocilizumab in patient with celiac disease and juvenile idiopathic arthritis

To the Editors, Celiac disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD), although their etiopathogenesis appear to be different and there are conflicting data about their association. The humanized anti- interleukin (IL)-6 receptor antibody tocilizumab is used for rheumatoid ar- thritis and sometimes for patients with UC refractory to conventional ther- apies. A few studies have reported that tocilizumab can aggravate pre-existing UC or cause de novo drug-induced IBD, probably because of failure to suppress intestinal IL-6 production. We report the case of a female pa- tient with a family history of CD and UC.