دورية أكاديمية
Immune-related adverse event-associated sclerosing cholangitis due to immune checkpoint inhibitors: imaging findings and treatments.
العنوان: | Immune-related adverse event-associated sclerosing cholangitis due to immune checkpoint inhibitors: imaging findings and treatments. |
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المؤلفون: | Okamoto K; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Hijioka S; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Nagashio Y; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Okada M; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Ohba A; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Maruki Y; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Kondo S; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Morizane C; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Ueno H; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan., Okusaka T; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan. |
المصدر: | Japanese journal of clinical oncology [Jpn J Clin Oncol] 2024 Aug 14; Vol. 54 (8), pp. 887-894. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 0313225 Publication Model: Print Cited Medium: Internet ISSN: 1465-3621 (Electronic) Linking ISSN: 03682811 NLM ISO Abbreviation: Jpn J Clin Oncol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Oxford : Oxford University Press Original Publication: Tokyo, Foundation of Clinical Oncology. |
مواضيع طبية MeSH: | Cholangitis, Sclerosing*/chemically induced , Cholangitis, Sclerosing*/diagnostic imaging , Cholangitis, Sclerosing*/pathology , Cholangitis, Sclerosing*/immunology , Cholangitis, Sclerosing*/drug therapy , Immune Checkpoint Inhibitors*/adverse effects, Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Tomography, X-Ray Computed ; Adult ; Aged, 80 and over |
مستخلص: | Objectives: Immune-related adverse event-sclerosing cholangitis caused by treatment with immune checkpoint inhibitors is rare, and the diagnostic criteria and treatment strategy remain unclear. In this study, we confirmed the clinicopathological features of immune-related adverse event-sclerosing cholangitis and clarified its diagnosis and appropriate management. Methods: We retrospectively evaluated 10 patients diagnosed with immune-related adverse event-sclerosing cholangitis and identified by electronic database searches. Results: Blood tests revealed liver dysfunction with a predominance of biliary tract enzymes in all patients; however, jaundice was present in only one patient. Contrast-enhanced computed tomography revealed diffuse hypertrophy of the extrahepatic bile duct wall as the most frequent finding; however, endoscopic retrograde cholangiopancreatography showed various imaging features, such as the pruned-tree appearance of intrahepatic bile ducts, in all patients. Transpapillary bile duct biopsy showed inflammatory cell infiltration using immunostaining, with a predominance of cluster of differentiation 8-positive T cells in 63% of the cases. Initial steroid therapy was effective in two cases. Mycophenolate mofetil and tacrolimus were used in steroid-refractory cases. Although six patients showed improvements, all of the remaining patients died owing to immune-related adverse event-sclerosing cholangitis. Conclusions: Various bile duct imaging findings of immune-related adverse event-sclerosing cholangitis were revealed; transpapillary bile duct biopsy may be useful in the diagnosis of immune-related adverse event-sclerosing cholangitis. Despite the combination of multiple immunosuppressive agents, prognosis of immune-related adverse event-sclerosing cholangitis remains poor. Longer follow-up and larger clinical studies are necessary to establish its treatment strategy. (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.) |
فهرسة مساهمة: | Keywords: cholangitis; endoscopic retrograde cholangiopancreatography; immune checkpoint inhibitors |
المشرفين على المادة: | 0 (Immune Checkpoint Inhibitors) |
تواريخ الأحداث: | Date Created: 20240508 Date Completed: 20240814 Latest Revision: 20240814 |
رمز التحديث: | 20240814 |
DOI: | 10.1093/jjco/hyae060 |
PMID: | 38715325 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1465-3621 |
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DOI: | 10.1093/jjco/hyae060 |