Successful Treatment of Nivolumab-related Cholangitis with Prednisolone: A Case Report and Review of the Literature

Internal Medicine
Koji SawadaToshikatsu Okumura

Abstract

The patient was a 76-year-old man who was treated with nivolumab due to recurrent gastric cancer. A blood examination revealed grade 3 alkaline phosphatase (ALP) elevation. A histopathological examination revealed marked portal infiltration, including eosinophils and CD4+ and CD8+ T lymphocytes, suggesting nivolumab-related cholangitis accompanied by the features of both an immune-related adverse event (irAE) and drug-induced liver injury (DILI) with allergic reaction. The patient's ALP level immediately decreased after the administration of prednisolone. Although nivolumab-related cholangitis, a rare irAE, has been reported to be refractory to steroid therapy, patients with features of irAE and allergic DILI might immediately respond to prednisolone.

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Citations

Apr 25, 2019·Clinical Endocrinology·Sirazum ChoudhuryKarim Meeran
Nov 22, 2019·Journal of Gastroenterology and Hepatology·Koji SawadaToshikatsu Okumura
Sep 5, 2020·Clinical Journal of Gastroenterology·Masakuni FujiiKazuhide Yamamoto
Jan 29, 2020·World Journal of Gastroenterology : WJG·Takumi OnoyamaHajime Isomoto
Jan 24, 2020·Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association·Benjamin L Woolbright

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Methods Mentioned

BETA
biopsy

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