Journal of Clinical Pediatrics >
Clinical application of tocilizumab in febrile infection-related epilepsy syndrome
Received date: 2025-05-07
Accepted date: 2025-07-23
Online published: 2026-03-06
Febrile infection-related epilepsy syndrome (FIRES) is a rare and catastrophic epileptic encephalopathy that predominantly affects school-aged children.Characterized by a biphasic clinical course, FIRES manifests as rapid progression to refractory status epilepticus following a preceding febrile infection. The prognosis of FIRES is dismal: the acute-phase mortality rate is approximately 10%, and survivors often develop chronic refractory epilepsy and cognitive impairment. The pathogenesis of FIRES remains unclear, but neuroinflammation involving cytokines such as IL-6 may play a key role. Tocilizumab, a humanized monoclonal antibody targeting the IL-6 receptor, exerts anti-inflammatory effects by blocking IL-6 signaling. For FIRES patients unresponsive to conventional anti-seizure medications (ASMs), first-line immunotherapies, or ketogenic diet, tocilizumab is currently recommended as a second-line immunotherapeutic option. This review summarizes the background, mechanisms, clinical applications, safety profile, and challenges associated with tocilizumab in FIRES management, aiming to update clinicians on the latest advances in this field..
CHEN Zhe , HONG Siqi . Clinical application of tocilizumab in febrile infection-related epilepsy syndrome[J]. Journal of Clinical Pediatrics, 2026 , 44(3) : 264 -269 . DOI: 10.12372/jcp.2026.25e0509
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