Relapse of systemic juvenile idiopathic arthritis after influenza vaccination in a patient receiving tocilizumab

We report the case of a patient with systemic juvenile idiopathic arthritis (s-JIA) receiving tocilizumab (TCZ) who experienced relapses of s-JIA after receiving influenza vaccination. Systemic symptoms of s-JIA might be masked during TCZ therapy. Careful observation with the monitoring of serum interleukin (IL)-18 and IL-6 levels may be useful.