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Cemiplimab-Associated Sinusoidal Obstruction Syndrome.

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  • 1University of Pittsburgh Department of Internal Medicine, Pittsburgh, PA.

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Summary
This summary is machine-generated.

A patient developed ascites and liver dysfunction after starting cemiplimab for advanced basal cell carcinoma. Doctors diagnosed sinusoidal obstruction syndrome, a rare side effect of this immunotherapy.

Keywords:
cemiplimabcheck-point inhibitornodular regenerative hyperplasiasinusoidal obstruction syndromeveno-occlusive disease

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Area of Science:

  • Hepatology
  • Oncology
  • Immunology

Background:

  • Checkpoint inhibitors, such as cemiplimab, are increasingly used for advanced basal cell carcinoma.
  • Immune-related adverse events (irAEs) can affect various organs, including the liver.
  • Sinusoidal obstruction syndrome (SOS) is a known complication of certain medical treatments.

Observation:

  • A 58-year-old woman presented with new-onset recurrent ascites following cemiplimab treatment.
  • Extensive investigations ruled out common causes of liver dysfunction and ascites.
  • Transjugular liver biopsy revealed parenchymal changes indicative of sinusoidal obstruction syndrome.

Findings:

  • Cemiplimab initiation was temporally associated with the development of ascites and liver dysfunction.
  • The patient's presentation and biopsy results confirmed sinusoidal obstruction syndrome.
  • This case highlights a potential, albeit rare, hepatic irAE of cemiplimab.

Implications:

  • Sinusoidal obstruction syndrome should be considered in patients developing liver dysfunction after checkpoint inhibitor therapy.
  • Early recognition and management of SOS may improve patient outcomes.
  • Further research is warranted to understand the incidence and mechanisms of SOS associated with immunotherapies.