医学
无容量
易普利姆玛
肝功能
黄疸
肝活检
腹水
内科学
胃肠病学
肝功能检查
免疫疗法
活检
外科
癌症
作者
Philipp Kasper,Anne Kristin Fischer,Jürgen Schumacher
出处
期刊:Case Reports
[BMJ]
日期:2024-09-01
卷期号:17 (9): e260066-e260066
标识
DOI:10.1136/bcr-2024-260066
摘要
A woman in her 50s presented to the hospital with new-onset jaundice and ascites. Her medical history included a melanoma of the right shoulder, diagnosed 8 months before, for which she had received four cycles of ipilimumab and nivolumab. Due to the oncological history and previous immunotherapy, an immune-checkpoint-inhibitor (ICI)-induced hepatitis was suspected, and a high-dose corticosteroid treatment was initiated. However, as there was no improvement in the liver function tests, a percutaneous liver biopsy was performed for further diagnostic clarification. Histological analysis ultimately identified a hepatic sinusoidal obstruction syndrome (SOS) as the underlying cause of liver dysfunction and portal hypertension. ICI-related hepatic SOS represents an extremely rare adverse event related to immunotherapy that should be considered in all patients with treatment-refractory ICI-related hepatotoxicity and clinical signs of portal hypertension.
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