Bortezomib-associated fatal liver failure in a haemodialysis patient with multiple myeloma

Bortezomib is a proteasome inhibitor with excellent antimyeloma activity. The most frequent toxic side effects are gastrointestinal, neuropathy and thrombocytopenia. The liver was not considered an important target organ for toxicity until one case of bortezomib-induced severe hepatitis was reported in a patient with multiple myeloma.

We describe a patient developing acute cholestatic and parenchymal hepatitis complicated by fatal liver failure after bortezomib therapy for multiple myeloma.

The importance of being aware of this potential fatal complication is emphasized considering that this drug is increasingly prescribed and in order to discontinue this drug if liver adverse reaction is suspected.