Acute Liver Failure following a Single Dose of Atezolizumab, as Assessed for Causality Using the Updated RUCAM. (23rd March 2022)

• Record Type: Journal Article
• Authors: Tzadok, Roie; Levy, Sharon; Aouizerate, Jessie; Shibolet, Oren
• Other Names: Machado Marcel Cerqueira Cesar Academic Editor.
• Is Part Of: Case reports in gastrointestinal medicine. Volume 2022(2022)
• Publication Date: 2022-03-23
• Subjects: Gastroenterology -- Case studies -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology; Gastrointestinal Diseases; Digestive organs -- Diseases; Gastroenterology; Electronic journals; Periodicals; Case studies; Periodicals; 616.33
• DOI: 10.1155/2022/5090200
• Languages: English
• ISSNs: 2090-6528

Abstract

Abstract : Immune checkpoint inhibitors have become major therapeutic agents in oncology over the last few years. However, they are associated with a variety of potentially severe autoimmune phenomena. We present a patient with advanced adenocarcinoma of the lung, who presented with acute liver injury two weeks following his first treatment with atezolizumab, rapidly deteriorating to fulminant liver failure. A thorough evaluation of infectious, vascular, metabolic, and autoimmune etiologies did not yield any results. Liver pathology was nonspecific. Using RUCAM as a causality assessment method indicated probable connection between atezolizumab and liver damage. To our knowledge, this is the first documented report of a patient developing acute liver failure shortly after immune checkpoint inhibitor initiation.