Secondary sclerosing cholangitis with hemobilia induced by pembrolizumab: Case report and review of published work

Yudai Koya; Michihiko Shibata; Nobuhiko Shinohara; Satoru Nebuya; Shinji Oe; Yuichi Honma; Michio Senju; Naoko Sato; Masaru Harada

doi:10.1111/hepr.13329

Secondary sclerosing cholangitis with hemobilia induced by pembrolizumab: Case report and review of published work

Hepatol Res. 2019 Aug;49(8):950-956. doi: 10.1111/hepr.13329. Epub 2019 Apr 10.

Authors

Yudai Koya¹, Michihiko Shibata¹, Nobuhiko Shinohara¹, Satoru Nebuya¹, Shinji Oe¹, Yuichi Honma¹, Michio Senju¹, Naoko Sato², Masaru Harada¹

Affiliations

¹ Third Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
² Department of Pathology, University of Occupational and Environmental Health, Kitakyushu, Japan.

PMID: 30861263
DOI: 10.1111/hepr.13329

Abstract

A 66-year-old man was admitted to our department due to cholestatic liver injury. He had received five cycles of pembrolizumab for small-cell lung cancer. Imaging showed the possibility of sclerosing cholangitis (SC) with hemobilia. Histologically, CD8⁺ T cells had infiltrated the biliary epithelium of the extrahepatic bile duct. We reached the diagnosis of secondary SC induced by pembrolizumab. Although we treated him with high-dose corticosteroids, laboratory data showed only a moderate response. Clinicians should recognize that immune checkpoint inhibitors can sometimes cause severe and irreversible SC.

Keywords: CD8-positive T cells; hemobilia; immune-related adverse effects; pembrolizumab; sclerosing cholangitis.

Publication types

Case Reports