Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review

Camrelizumab (SHR-1210), a human monoclonal antibody against programmed death receptor 1 (PD-1), blocks the binding of PD-1 to PD-L1, consequently inhibiting immune system evasion by tumor cells. A 65-year-old man underwent radical esophagectomy 5 months ago following the diagnosis of esophageal can...

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Autores principales:	Tan Youwen, Ye Yun, Chen Li
Formato:	article
Lenguaje:	EN
Publicado:	De Gruyter 2021
Materias:	camrelizumab immune-related hepatitis intrahepatic cholestasis immune-related pneumonia Medicine R
Acceso en línea:	https://doaj.org/article/52c24670e15c44d689aca5bf910ff9d6
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spelling	oai:doaj.org-article:52c24670e15c44d689aca5bf910ff9d62021-12-05T14:10:54ZFatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review2391-546310.1515/med-2021-0267https://doaj.org/article/52c24670e15c44d689aca5bf910ff9d62021-04-01T00:00:00Zhttps://doi.org/10.1515/med-2021-0267https://doaj.org/toc/2391-5463Camrelizumab (SHR-1210), a human monoclonal antibody against programmed death receptor 1 (PD-1), blocks the binding of PD-1 to PD-L1, consequently inhibiting immune system evasion by tumor cells. A 65-year-old man underwent radical esophagectomy 5 months ago following the diagnosis of esophageal cancer by gastroscopy. Approximately 40 days later, capecitabine was administered at a dosage of 1.5 g Po bid for 14 days, and anti-PD-1 (camrelizumab 200 mg) was administered twice. Around 20 days later, abnormal liver function was detected. He received a diagnosis of drug-induced liver injury. Chest computed tomography scanning revealed interstitial inflammatory lesions in both lower lungs. Liver biopsy revealed immune injury with ductopenia. Therefore, the diagnosis was revised as immune-related pneumonia and hepatitis associated with camrelizumab. The treatment regimen of methylprednisolone was adjusted to 40 mg/day and gradually increased to 80 mg/day. Mycophenolate mofetil was administered at a dose of 2 g/day. Consequently, chest tightness and shortness of breath resolved, and pulmonary inflammation improved. However, jaundice did not improve and continued to exacerbate. The last measured prothrombin time was 41 s, prothrombin activity was 19%, and the international normalized ratio was 4.03. The cause of death was diagnosed as liver failure, cardiopulmonary failure, and septic shock.Tan YouwenYe YunChen LiDe Gruyterarticlecamrelizumabimmune-related hepatitisintrahepatic cholestasisimmune-related pneumoniaMedicineRENOpen Medicine, Vol 16, Iss 1, Pp 553-557 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	camrelizumab immune-related hepatitis intrahepatic cholestasis immune-related pneumonia Medicine R
spellingShingle	camrelizumab immune-related hepatitis intrahepatic cholestasis immune-related pneumonia Medicine R Tan Youwen Ye Yun Chen Li Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
description	Camrelizumab (SHR-1210), a human monoclonal antibody against programmed death receptor 1 (PD-1), blocks the binding of PD-1 to PD-L1, consequently inhibiting immune system evasion by tumor cells. A 65-year-old man underwent radical esophagectomy 5 months ago following the diagnosis of esophageal cancer by gastroscopy. Approximately 40 days later, capecitabine was administered at a dosage of 1.5 g Po bid for 14 days, and anti-PD-1 (camrelizumab 200 mg) was administered twice. Around 20 days later, abnormal liver function was detected. He received a diagnosis of drug-induced liver injury. Chest computed tomography scanning revealed interstitial inflammatory lesions in both lower lungs. Liver biopsy revealed immune injury with ductopenia. Therefore, the diagnosis was revised as immune-related pneumonia and hepatitis associated with camrelizumab. The treatment regimen of methylprednisolone was adjusted to 40 mg/day and gradually increased to 80 mg/day. Mycophenolate mofetil was administered at a dose of 2 g/day. Consequently, chest tightness and shortness of breath resolved, and pulmonary inflammation improved. However, jaundice did not improve and continued to exacerbate. The last measured prothrombin time was 41 s, prothrombin activity was 19%, and the international normalized ratio was 4.03. The cause of death was diagnosed as liver failure, cardiopulmonary failure, and septic shock.
format	article
author	Tan Youwen Ye Yun Chen Li
author_facet	Tan Youwen Ye Yun Chen Li
author_sort	Tan Youwen
title	Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
title_short	Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
title_full	Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
title_fullStr	Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
title_full_unstemmed	Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
title_sort	fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: a case report and literature review
publisher	De Gruyter
publishDate	2021
url	https://doaj.org/article/52c24670e15c44d689aca5bf910ff9d6
work_keys_str_mv	AT tanyouwen fatalimmunerelatedhepatitiswithintrahepaticcholestasisandpneumoniaassociatedwithcamrelizumabacasereportandliteraturereview AT yeyun fatalimmunerelatedhepatitiswithintrahepaticcholestasisandpneumoniaassociatedwithcamrelizumabacasereportandliteraturereview AT chenli fatalimmunerelatedhepatitiswithintrahepaticcholestasisandpneumoniaassociatedwithcamrelizumabacasereportandliteraturereview
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Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review

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