Murayama Aiko, Tajiri Kazuto, Nakaya Atsuko, Ito Hiroyuki, Hayashi Yuka, Entani Toshiki, Nagata Kohei, Tanaka Shinichi, Hamashima Takeru, Yasuda Ichiro
The Third Department of Internal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan.
Department of Gastroenterology, Takaoka Municipal Hospital, Takaoka, Japan.
Case Rep Gastroenterol. 2021 Jul 13;15(2):645-651. doi: 10.1159/000516199. eCollection 2021 May-Aug.
The increased use of immune-checkpoint inhibitors to treat various types of cancer has increased the incidence of immune-related adverse events (irAEs). Hepatic irAEs are frequent and can lead to serious conditions. Among the various types of hepatic irAEs reported to date, bile duct injury has been shown refractory to steroid treatment. This study describes 2 patients with hepatic irAEs manifesting as intrahepatic bile duct injury. Immunostaining with antibodies to both CD8 and cytokeratin-7 was useful for the diagnosis, and both patients were refractory to steroid treatment. Prompt diagnosis and active immunosuppressive therapies are required in such cases.
免疫检查点抑制剂在治疗各类癌症中的使用增加，导致免疫相关不良事件（irAEs）的发生率上升。肝脏irAEs很常见，且可能导致严重情况。在迄今报道的各类肝脏irAEs中，胆管损伤已显示对类固醇治疗无效。本研究描述了2例表现为肝内胆管损伤的肝脏irAEs患者。用抗CD8和细胞角蛋白-7抗体进行免疫染色有助于诊断，且两名患者对类固醇治疗均无效。在此类病例中需要及时诊断和积极的免疫抑制治疗。
