Severe immune-mediated hepatitis caused by sindilizumab combined with local radiotherapy: a case report

Eur J Hosp Pharm. 2024 Jun 21;31(4):381-383. doi: 10.1136/ejhpharm-2023-003849.

Abstract

A man with diffuse large B-cell lymphoma in the nasal cavity was treated with sindilizumab, an immune checkpoint inhibitor, combined with local radiotherapy for multiple nodules of the left upper arm. After a single administration of sindilizumab and 10 radiotherapy treatments, the patient presented with liver dysfunction. Liver function tests showed that the levels of transaminases had increased abnormally and deteriorated though with intense treatment. His bilirubin level was also increased with obvious yellow staining of the skin and sclera. The patient was considered to have severe immune-mediated hepatitis (IMH) caused by sindilizumab combined with local radiotherapy. His liver function did not improve and he died of organ failure. This is a case of rare liver failure which was considered to be IMH induced by synergistic treatment with immune checkpoint therapy and radiotherapy.

Keywords: Adverse Drug Reaction Reporting Systems; Case Reports; DRUG-RELATED SIDE EFFECTS AND ADVERSE REACTIONS; RADIOLOGY; Safety.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Fatal Outcome
  • Hepatitis / etiology
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Immune Checkpoint Inhibitors / therapeutic use
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Lymphoma, Large B-Cell, Diffuse* / radiotherapy
  • Male
  • Middle Aged
  • Nose Neoplasms / radiotherapy

Substances

  • Antibodies, Monoclonal, Humanized
  • Immune Checkpoint Inhibitors