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Vol.64 No.3 contents | Japanese/English |
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- Case Report -
Immune Checkpoint Inhibitor-induced Sclerosing Cholangitis: Three Cases Reported from Our Hospital
Nao Takada1, Takahiro Fukui1, Hidehiro Irie1, Yohei Funatsu1, Hidefumi Koh11Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, Japan
Background. In recent years, immune checkpoint inhibitors (ICIs) have been mainly used to treat oncogenic driver-negative non-small cell lung cancer and have been found to be effective. However, they are associated with side effects such as immune-related adverse events (irAEs), which can occasionally be severe. One such irAE is secondary sclerosing cholangitis (SSC), a rare disease for which limited information is available. Cases. We reviewed the clinical courses of three patients with SSC. All patients experienced liver and biliary dysfunction, either when they were taking ICIs or after the termination of ICIs. Magnetic resonance cholangiopancreatography (MRCP) revealed intrahepatic bile duct strictures in one patient and intrahepatic and extrahepatic bile duct changes in the other two. All three patients were treated with corticosteroids, which were effective in the patient with only intrahepatic bile duct changes and in one patient with both intrahepatic and extrahepatic changes. However, corticosteroid therapy was not helpful for the third patient with intrahepatic and extrahepatic changes. Conclusion. We discuss the clinical features of three patients with SSC. Some studies have reported that the efficacy of corticosteroid therapy for SSC relies on the position of dilation or constriction in the bile ducts. The relationship between the area of cholangitis and the efficacy of corticosteroid treatment still remains to be clarified; however, only intrahepatic bile duct changes may positively respond to corticosteroid treatment.
key words: Immune checkpoint inhibitor, Immune-related adverse event (irAE), Sclerosing cholangitis, Corticosteroids, Magnetic resonance cholangiopancreatography (MRCP)
Received: August 29, 2023
Accepted: March 11, 2024
JJLC 64 (3): 193-199, 2024
