Resolution of Crizotinib-Associated Fulminant Hepatitis following Cessation of Treatment
Targeted cancer treatments offer the prospect of precise inhibition of tumor growth without the untoward off-target toxicity of traditional chemotherapies. Still, unintended, often idiosyncratic side effects, such as drug-induced liver injury, can occur. We discuss the case of a 26-year-old female w...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2018/3413592 |
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| author | Gregory W. Charville Sukhmani K. Padda Richard K. Sibley Ajithkumar Puthillath Paul Y. Kwo |
| author_facet | Gregory W. Charville Sukhmani K. Padda Richard K. Sibley Ajithkumar Puthillath Paul Y. Kwo |
| author_sort | Gregory W. Charville |
| collection | DOAJ |
| description | Targeted cancer treatments offer the prospect of precise inhibition of tumor growth without the untoward off-target toxicity of traditional chemotherapies. Still, unintended, often idiosyncratic side effects, such as drug-induced liver injury, can occur. We discuss the case of a 26-year-old female with a history of ROS1-rearranged lung adenocarcinoma, undergoing treatment with the tyrosine kinase inhibitor crizotinib, who presented to our hospital with abdominal pain and scleral icterus. Liver chemistries were notable for hyperbilirubinemia (5 mg/dL total) and marked transaminasemia (AST 1736 U/L, ALT >3500 U/L); liver biopsy demonstrated acute hepatitis with extensive necrosis. There was no evidence of an infectious or autoimmune etiology. It was discovered that the patient was taking a 500 mg once daily dose of crizotinib, in lieu of the intended dose of 250 mg twice daily. After immediate cessation of crizotinib therapy upon hospital admission, there was complete biochemical resolution of the hepatitis. This case highlights the potential reversibility of fulminant crizotinib-associated hepatoxicity, possibly related to supratherapeutic dosing, when managed with abrupt stoppage of the drug and initiation of supportive care. |
| format | Article |
| id | doaj-art-e7b882e8aeb645528f7135a57e443169 |
| institution | Kabale University |
| issn | 2090-6587 2090-6595 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hepatology |
| spelling | doaj-art-e7b882e8aeb645528f7135a57e4431692025-02-03T05:46:15ZengWileyCase Reports in Hepatology2090-65872090-65952018-01-01201810.1155/2018/34135923413592Resolution of Crizotinib-Associated Fulminant Hepatitis following Cessation of TreatmentGregory W. Charville0Sukhmani K. Padda1Richard K. Sibley2Ajithkumar Puthillath3Paul Y. Kwo4Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USAStockton Hematology Oncology Medical Group, Stockton, CA 95204, USADepartment of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94305, USATargeted cancer treatments offer the prospect of precise inhibition of tumor growth without the untoward off-target toxicity of traditional chemotherapies. Still, unintended, often idiosyncratic side effects, such as drug-induced liver injury, can occur. We discuss the case of a 26-year-old female with a history of ROS1-rearranged lung adenocarcinoma, undergoing treatment with the tyrosine kinase inhibitor crizotinib, who presented to our hospital with abdominal pain and scleral icterus. Liver chemistries were notable for hyperbilirubinemia (5 mg/dL total) and marked transaminasemia (AST 1736 U/L, ALT >3500 U/L); liver biopsy demonstrated acute hepatitis with extensive necrosis. There was no evidence of an infectious or autoimmune etiology. It was discovered that the patient was taking a 500 mg once daily dose of crizotinib, in lieu of the intended dose of 250 mg twice daily. After immediate cessation of crizotinib therapy upon hospital admission, there was complete biochemical resolution of the hepatitis. This case highlights the potential reversibility of fulminant crizotinib-associated hepatoxicity, possibly related to supratherapeutic dosing, when managed with abrupt stoppage of the drug and initiation of supportive care.http://dx.doi.org/10.1155/2018/3413592 |
| spellingShingle | Gregory W. Charville Sukhmani K. Padda Richard K. Sibley Ajithkumar Puthillath Paul Y. Kwo Resolution of Crizotinib-Associated Fulminant Hepatitis following Cessation of Treatment Case Reports in Hepatology |
| title | Resolution of Crizotinib-Associated Fulminant Hepatitis following Cessation of Treatment |
| title_full | Resolution of Crizotinib-Associated Fulminant Hepatitis following Cessation of Treatment |
| title_fullStr | Resolution of Crizotinib-Associated Fulminant Hepatitis following Cessation of Treatment |
| title_full_unstemmed | Resolution of Crizotinib-Associated Fulminant Hepatitis following Cessation of Treatment |
| title_short | Resolution of Crizotinib-Associated Fulminant Hepatitis following Cessation of Treatment |
| title_sort | resolution of crizotinib associated fulminant hepatitis following cessation of treatment |
| url | http://dx.doi.org/10.1155/2018/3413592 |
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