Gastroenterology, NHS Greater Glasgow and Clyde, Glasgow, UK
Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK.
BMJ Case Rep. 2021 May 28;14(5):e241700. doi: 10.1136/bcr-2021-241700.
A 69-year-old retired miner with stage 4 non-small-cell lung cancer presented with a 2-month history of obstructive liver function tests following nivolumab immunotherapy. His case had not responded to high dose prednisolone or mycophenolate and he was admitted for investigation. MR cholangiopancreatography demonstrated areas of intrahepatic biliary tree beading and stricturing, in keeping with sclerosing cholangitis. Prednisolone and mycophenolate were stopped and ursodeoxycholic acid commenced with subsequent partial improvement of the patient's liver function tests.
一位 69 岁的退休矿工患有 4 期非小细胞肺癌，在接受 nivolumab 免疫治疗后出现了 2 个月的阻塞性肝功能检查病史。他的病情对大剂量泼尼松龙或吗替麦考酚酯没有反应，因此入院进行检查。磁共振胆胰管成像显示肝内胆管呈串珠状和狭窄，符合硬化性胆管炎。停止使用泼尼松龙和吗替麦考酚酯，并开始使用熊去氧胆酸，随后患者的肝功能检查有所部分改善。
