A Case of Imatinib-Induced Hepatitis

Abstract

A 71-year-old female with a past medical history of Philadelphia chromosome-positive chronic myelogenous leukemia on imatinib therapy, Sjogren’s syndrome, and hypothyroidism presents with acute hepatitis. After a comprehensive workup ruling out viral, infectious and metabolic etiologies imatinib is stopped which results in immediate improvement. The biopsy is consistent with drug-induced liver damage; the patient is started on oral prednisone and discharged. Unfortunately, our patient’s liver function does not improve over the course of the next week and she is readmitted for hepatic and renal failure. During this second admission patient’s condition continues to deteriorate with concomitant gastric bleeding, renal injury, and cellulitis. She ultimately chooses a palliative approach.

A Case of Immune‐Mediated Liver Injury Induced by Olaparib

“…In our case, several features oriented toward IM‐DILI, i.e., the absence of advanced liver fibrosis at presentation, the prominent eosinophilic infiltrate, and, chiefly, the sustained remission after the rapid tapering of steroid therapy. Furthermore, other checkpoint inihibitors, such as imatinib, have already been associated with IM‐DILI …”

“…Furthermore, other checkpoint inihibitors, such as imatinib, have already been associated with IM-DILI. (5)…”

Сase Report of Acute Toxic Imatinib-induced Hepatitis in a Patient with Chronic Myeloid Leukemia, Sulfa Allergy, and Rheumatoid Arthritis

“…In severe hepatotoxicity cases, liver transplantation can be a life-saving treatment approach. The decision should be individualized for each patient based on King’s College Hospital criteria for predicting mortality in acute liver failure [ 18 - 20 ]. Nowadays, many cases of clinical response with a decrease in hepatotoxicity have been described in cases of simultaneous prednisolone administration.…”

“…Steroid therapy can cause complications such as hypokalemia and acute gastrointestinal bleeding [ 20 ]. In this report, the features of the concomitant therapy of such patients are presented, which had not been previously described.…”

Imatinib and liver toxicity

“…The onset of acute liver injury may range from a few days to several years from starting imatinib 10. The pattern of liver injury is usually hepatocellular in most cases, although cholestatic derangements have also been described 11. In addition, reactivation of chronic HBV infection as a consequence of immunosuppression has been reported following treatment with imatinib 12…”