1. Rapid Progression of Liver Fibrosis Induced by Acute Liver Injury Due to Immune-related Adverse Events of Atezolizumab
- Author
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Shintaro Abe, Yuichi Honma, Kahori Morino, Hiroki Matsumiya, Yudai Koya, Shinji Oe, Masaru Harada, Tomonori Gohda, Michihiko Shibata, Shinji Shinohara, Keiichiro Kumamoto, Tsuguru Hayashi, Aya Miyama, Koichiro Miyagawa, Akihiro Taira, Masashi Kusanaga, and Fumihiro Tanaka
- Subjects
Liver Cirrhosis ,atezolizumab ,medicine.medical_specialty ,immune checkpoint inhibitor ,Case Report ,Autoimmune hepatitis ,Acute Inflammatory Infiltrate ,030204 cardiovascular system & hematology ,Antibodies, Monoclonal, Humanized ,Chronic liver disease ,Gastroenterology ,sequential liver biopsy ,03 medical and health sciences ,0302 clinical medicine ,Atezolizumab ,Internal medicine ,immune-related adverse event ,Internal Medicine ,medicine ,Humans ,Adverse effect ,Lung cancer ,Aged ,liver fibrosis ,autoimmune hepatitis ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,General Medicine ,medicine.disease ,Hepatocellular carcinoma ,Liver biopsy ,Female ,030211 gastroenterology & hepatology ,business - Abstract
A 72-year-old woman with advanced lung cancer had received systemic chemotherapy including atezolizumab. About three months after the initial administration of atezolizumab, her liver enzyme levels increased. The histopathological findings of the initial liver biopsy revealed acute inflammatory infiltrate, predominantly CD3+, CD4+ and CD8+ T lymphocytes, in the hepatic lobules. We diagnosed her with atezolizumab-induced immune-related acute hepatitis. Oral corticosteroid therapy successfully improved the elevation of serum aminotransferases. A sequential liver biopsy demonstrated the rapid progression of liver fibrosis. Because hepatocellular carcinoma occurs most often in advanced cases of chronic liver disease, we should pay close attention to immune-related acute hepatic injury when treating patients with advanced liver diseases using atezolizumab.
- Published
- 2021