The patient with grade 4 CRS presented with fever, dyspnea, and hypotension and did not respond to tocilizumab or corticosteroids, and developed dose-limiting toxicity (DLT), and his serum IL-6, IFN-γ, and TNF-α levels were relatively higher than others (Fig. 7E). This evidence concerns the gene IL6 and congenital rubella syndrome.