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Immune-mediated hepatitis caused by toripalimab: A case report
Summary
Prolonged toripalimab use can cause immune-mediated hepatitis (IMH) in non-small cell lung cancer (NSCLC) patients, even after 17 months. Early vigilance and glucocorticoid treatment are key for managing this adverse reaction.
Area of Science:
- Oncology
- Immunology
- Hepatology
Background:
- Toripalimab, an anti-PD-1 antibody, is a standard treatment for non-small cell lung cancer (NSCLC).
- Immune-mediated hepatitis (IMH) is a known side effect of immune checkpoint inhibitors (ICIs).
- Typically, ICI-related IMH occurs within weeks to months of treatment initiation.
Observation:
- This report details a case of IMH in an NSCLC patient after approximately 17 months of toripalimab therapy.
- This presentation is unusual, as IMH typically manifests earlier in ICI treatment.
Findings:
- Immune-mediated hepatitis (IMH) can occur late in the course of toripalimab treatment.
- Toripalimab-induced IMH requires vigilant monitoring for symptoms, diagnosis, and pathological features.
- Prompt treatment with glucocorticoids, such as methylprednisolone, effectively reduces liver enzyme elevations.
Implications:
- Clinicians must maintain vigilance for late-onset IMH during prolonged toripalimab therapy.
- This case expands the understanding of the temporal profile of toripalimab-related adverse events.
- Effective management strategies for toripalimab-induced IMH involve early detection and glucocorticoid intervention.
