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Immunotherapy ; 11(18): 1527-1531, 2019 12.
Article in English | MEDLINE | ID: mdl-31789069

ABSTRACT

Immune checkpoint inhibitor therapy has become a cornerstone in the management of many oncologic diseases. Although it is well tolerated in most patients, a wide spectrum of adverse events has been described as a result of immune system alteration. We present a case of a woman with metastatic bronchogenic adenocarcinoma who was initially thought to have immune-mediated hepatitis, but eventually discovered to have a rarely described immune-mediated cholangiopathy. Her cholangiopathy appeared to stabilize following ursodeoxycholic acid and tocilizumab after several lines of guideline-directed therapy. Awareness of this unique toxicity following immune checkpoint inhibitor, and potential treatment options may help clinicians manage this rare but serious complication.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents, Immunological/adverse effects , Bile Duct Diseases/chemically induced , Bile Duct Diseases/drug therapy , Nivolumab/adverse effects , Ursodeoxycholic Acid/therapeutic use , Adenocarcinoma of Lung/pathology , Adenocarcinoma of Lung/therapy , Bile Duct Diseases/pathology , Bile Duct Diseases/physiopathology , Cholagogues and Choleretics/therapeutic use , Drug-Related Side Effects and Adverse Reactions/drug therapy , Drug-Related Side Effects and Adverse Reactions/pathology , Drug-Related Side Effects and Adverse Reactions/physiopathology , Female , Humans , Immunotherapy/adverse effects , Lung Neoplasms/pathology , Lung Neoplasms/therapy , Middle Aged , Treatment Outcome
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