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Multicentric Castleman disease is a disease which is with significant symptoms. In a part of pathogenesis the underlying role of interleukin-6 is considered as multi-agent chemotherapy and targeted maintenance therapy with tocilizumab. Drug is been given as part of immunosuppressive intervention in a severe acute graÃâ-versus-host-disease aÃâer allogeneic stem cell transplantation for the improvement of the clinical symptoms in 48hours. They may be also a window of opportunity to suppress other inflammatory processes and it has not yet explored. Here is a case of an adolescent girl with relapsed acute lymphoblastic leukaemia who was admitted to the hospital with an initiated neutropenic fever. She developed tachycardia, hypotension and was transferred to pediatric intensive care unit where, she was started on inotropic support. As the clinical course was worsen for development of multi-organ failure requiring maximal intensive care support, including high frequency oscillatory ventilation, nitric oxide inhalation, further extending inotropic support with epinephrine, norepinephrine, dobutamine and continuous renal replacement therapy. The neutrophil count of was maintained, next respiratory condition has come to worse and it lead to ventilate.Though these finding is limited to only a patient, the transient improvement of condition may suggest potential efficacy of Tocilizumab.
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