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Related Concept Videos

Autoimmune Disorders01:29

Autoimmune Disorders

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Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
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The immune...
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Diseases of the Liver and Gallbladder01:26

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Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
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Cytomegalovirus Disease01:27

Cytomegalovirus Disease

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Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
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Hepatitis01:25

Hepatitis

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Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
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Viral Hepatitis I: Introduction01:28

Viral Hepatitis I: Introduction

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Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion...
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Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

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Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
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Ribociclib-induced autoimmune-like hepatitis: a case report.

Gozde Kavgaci1, Taha Koray Sahin1, Cenk Sokmensuer2

  • 1Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkiye.

Journal of Chemotherapy (Florence, Italy)
|November 29, 2024
PubMed
Summary

Hormone receptor-positive breast cancer patients treated with ribociclib may develop drug-induced autoimmune-like hepatitis. Careful monitoring and management are crucial for balancing treatment efficacy and liver safety.

Keywords:
Breast cancerautoimmune-like hepatitisdrug-induced liver injuryribociclib

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Area of Science:

  • Oncology
  • Hepatology
  • Pharmacology

Background:

  • Hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer is the most common subtype.
  • Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors plus endocrine therapy (ET) improve survival but can cause liver dysfunction.
  • Ribociclib, a CDK4/6 inhibitor, is associated with elevated liver enzymes and severe liver dysfunction.

Purpose of the Study:

  • To report a case of drug-induced autoimmune-like hepatitis (DI-ALH) in a patient with metastatic breast cancer treated with ribociclib.
  • To highlight the importance of multidisciplinary management in addressing hepatotoxicity during CDK4/6 inhibitor therapy.

Main Methods:

  • Case report of a 44-year-old woman with HR+/HER2- metastatic breast cancer.
  • Patient received ribociclib, letrozole, and goserelin, developing grade 3 hepatotoxicity.
  • Diagnosis of DI-ALH confirmed by liver biopsy; management included prednisolone and azathioprine, with subsequent ribociclib reintroduction.

Main Results:

  • The patient developed grade 3 hepatotoxicity, diagnosed as DI-ALH.
  • Successful management with immunosuppressive therapy allowed for ribociclib reintroduction and dose escalation.
  • The case demonstrates the feasibility of managing ribociclib-induced hepatotoxicity.

Conclusions:

  • Drug-induced autoimmune-like hepatitis is a potential complication of ribociclib therapy in HR+/HER2- breast cancer.
  • A multidisciplinary approach involving oncologists and hepatologists is essential for managing hepatotoxicity.
  • Balancing oncologic goals with hepatologic safety is critical for patient outcomes.