Occurrence of hepatitis in an elderly woman during the treatment of pembrolizumab for right advanced renal pelvis, ureteral cancer, and bladder cancer

Abstract

Recently, the use of immune checkpoint inhibitors (ICIs) with or without chemotherapeutic agents has been increasing in the treatment for advanced cancer. Here, we report the occurrence of liver failure after the use of pembrolizumab in an 82-year-old woman with metastatic liver disease derived from right advanced renal pelvis, ureteral cancer, and bladder cancer. She was successfully treated with 0.6 mg/kg daily prednisolone. In patients treated with ICIs, ICI-induced hepatitis is occasionally observed. Even if patients are older, it appears important to diagnose and treat ICI-induced hepatitis earlier by multidisciplinary therapies including steroid treatment. This is a first report of pembrolizumab-induced liver failure in elder patient with age over 80 years. Even if patients are older, it appears important to diagnose and treat ICI-induced hepatitis earlier by multidisciplinary therapies including steroid treatment.

Chronic Hepatitis C: Acute Exacerbation and Alanine Aminotransferase Flare

“…In cancer patients, liver dysfunction may be caused by something other than HCV infection, such as circulation failure, viral hepatitis, metabolic syndrome, cancer metastasis and direct invasion to the liver, autoimmune liver disease, drug-induced liver injury, or immune checkpoint inhibitor hepatitis [ 108 , 109 ]. In these patients, liver biopsy may not be performed due to hematological disorders.…”