文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期，新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

卡瑞利珠单抗治疗乙肝表面抗原血清学清除的肝细胞癌后发生的致命性慢加急性肝衰竭：一例报告及文献综述

Fatal acute-on-chronic liver failure following camrelizumab for hepatocellular carcinoma with HBsAg seroclearance: a case report and literature review.

作者信息

Li Fenghui, Wang Tao, Tang Fei, Liang Jing

机构信息

Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extra-corporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin, China.

出版信息

Front Med (Lausanne). 2023 Aug 14;10:1231597. doi: 10.3389/fmed.2023.1231597. eCollection 2023.

DOI:10.3389/fmed.2023.1231597
PMID:37644988
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10461443/
Abstract

In the last few years, immune checkpoint inhibitors (ICIs) have become major therapeutic agents for the treatment of advanced hepatocellular carcinoma (HCC). However, immunotherapy can activate hepatitis B virus (HBV), and immune clearance may lead to liver failure and even life-threatening conditions. Here we report a case of HCC with HBV-related cirrhosis that caused severe liver injury and rapidly progressed to fatal acute-on-chronic liver failure (ACLF) after only once application of camrelizumab; the patient underwent serological conversion of hepatitis B surface antigen (HBsAg) with liver injury. The patient's condition progressed rapidly. We added corticosteroids and applied plasma dialysis, along with tenofovir alafenamide (TAF) to control HBV. However, the patient eventually died of liver failure. To our knowledge, there are few reports of HBsAg clearance due to ICIs accompanied by fatal acute-on-chronic liver failure shortly after ICIs initiation. These results suggest that ICIs can cause fatal liver injury in a short term; in patients with chronic HBV infection, ICIs use may promote serological conversion of HBsAg.

摘要

在过去几年中，免疫检查点抑制剂（ICIs）已成为治疗晚期肝细胞癌（HCC）的主要治疗药物。然而，免疫疗法可激活乙型肝炎病毒（HBV），免疫清除可能导致肝衰竭甚至危及生命的情况。在此，我们报告一例HBV相关性肝硬化的HCC患者，该患者在仅一次应用卡瑞利珠单抗后发生严重肝损伤，并迅速进展为致命的慢加急性肝衰竭（ACLF）；患者出现肝损伤伴乙型肝炎表面抗原（HBsAg）血清学转换。患者病情进展迅速。我们加用了皮质类固醇并进行了血浆透析，同时应用替诺福韦艾拉酚胺（TAF）来控制HBV。然而，患者最终死于肝衰竭。据我们所知，很少有关于ICIs导致HBsAg清除并在开始ICIs后不久伴有致命性慢加急性肝衰竭的报道。这些结果表明，ICIs可在短期内导致致命性肝损伤；在慢性HBV感染患者中，使用ICIs可能促进HBsAg的血清学转换。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0e5/10461443/cece21a602a0/fmed-10-1231597-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0e5/10461443/1d4dee764e3b/fmed-10-1231597-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0e5/10461443/960d38ea3778/fmed-10-1231597-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0e5/10461443/cece21a602a0/fmed-10-1231597-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0e5/10461443/1d4dee764e3b/fmed-10-1231597-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0e5/10461443/960d38ea3778/fmed-10-1231597-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0e5/10461443/cece21a602a0/fmed-10-1231597-g003.jpg

相似文献

[1]
Fatal acute-on-chronic liver failure following camrelizumab for hepatocellular carcinoma with HBsAg seroclearance: a case report and literature review.

Front Med (Lausanne). 2023-8-14

[2]
Natural history of chronic hepatitis B virus infection in adults with emphasis on the occurrence of cirrhosis and hepatocellular carcinoma.

J Gastroenterol Hepatol. 2000-5

[3]
Impact of HBsAg seroclearance on late recurrence of hepatitis B virus-related hepatocellular carcinoma after surgical resection.

J Hepatol. 2022-10

[4]
Risk of Hepatitis B Virus Reactivation in Patients Treated With Immunotherapy for Anti-cancer Treatment.

Clin Gastroenterol Hepatol. 2022-4

[5]
Long-term outcome after hepatitis B surface antigen seroclearance in patients with chronic hepatitis B.

Am J Med. 2006-1

[6]
HBsAg Seroclearance in chronic hepatitis B in Asian patients: replicative level and risk of hepatocellular carcinoma.

Gastroenterology. 2008-10

[7]
Hepatitis B virus large surface protein is priming for hepatocellular carcinoma development via induction of cytokinesis failure.

J Pathol. 2018-11-16

[8]
HBsAg seroclearance in chronic hepatitis B in the Chinese: virological, histological, and clinical aspects.

Hepatology. 2004-6

[9]
Long-term outcomes and predictive scores for hepatocellular carcinoma and hepatitis B surface antigen seroclearance after hepatitis B e-antigen seroclearance.

Hepatology. 2018-6-6

[10]
Clinical features of HBsAg seroclearance in hepatitis B virus carriers in South Korea: A retrospective longitudinal study.

World J Gastroenterol. 2016-11-28

引用本文的文献

[1]
Advances in mechanistic investigation and treatment of steroid-refractory ICI-induced liver injury.

Clin Exp Med. 2025-8-11

[2]
Management of Hepatitis B Virus and Hepatitis C Virus Infections in Patients with Cancer Receiving Immune Checkpoint Inhibitors.

J Immunother Precis Oncol. 2024-5-2

本文引用的文献

[1]
The scientific basis of combination therapy for chronic hepatitis B functional cure.

Nat Rev Gastroenterol Hepatol. 2023-4

[2]
Application of artificial liver in immune-related liver injury induced by immune checkpoint inhibitor: Case reports and review of the literature.

Front Immunol. 2022

[3]
Acute Liver Failure following a Single Dose of Atezolizumab, as Assessed for Causality Using the Updated RUCAM.

Case Rep Gastrointest Med. 2022-3-23

[4]
Clinical practice of transarterial chemoembolization for hepatocellular carcinoma: consensus statement from an international expert panel of International Society of Multidisciplinary Interventional Oncology (ISMIO).

Hepatobiliary Surg Nutr. 2021-10

[5]
Risk of Hepatitis B Virus Reactivation in Patients Treated With Immunotherapy for Anti-cancer Treatment.

Clin Gastroenterol Hepatol. 2022-4

[6]
Hepatobiliary Cancers, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology.

J Natl Compr Canc Netw. 2021-5-1

[7]
Advances in drug development for hepatocellular carcinoma: clinical trials and potential therapeutic targets.

J Exp Clin Cancer Res. 2021-5-18

[8]
Hepatitis Flare During Immunotherapy in Patients With Current or Past Hepatitis B Virus Infection.

Am J Gastroenterol. 2021-6-1

[9]
Camrelizumab in Combination with Apatinib in Patients with Advanced Hepatocellular Carcinoma (RESCUE): A Nonrandomized, Open-label, Phase II Trial.

Clin Cancer Res. 2021-2-15

[10]
Clinical Characteristics and Adverse Impact of Hepatotoxicity due to Immune Checkpoint Inhibitors.

Am J Gastroenterol. 2020-2

文献AI研究员

20分钟写一篇综述，助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索