Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Nivolumab Induces Sustained Liver Injury in a Patient with Malignant Melanoma
Tokuhiro MatsubaraTsutomu NishidaYu HigakiRyo TomitaHiromi ShimakoshiAkiyoshi ShimodaNaoto OsugiAya SugimotoKei TakahashiDai NakamatsuKaori MukaiMasashi YamamotoKoji FukuiShiro AdachiMasami Inada
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2018 Volume 57 Issue 12 Pages 1789-1792


A 42-year-old man was diagnosed with cStage IIIb malignant melanoma and underwent resection. After interferon-beta therapy, 18-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) showed multiple lung metastases, and he received nivolumab (2 mg/kg) every 3 weeks, resulting in a total of 17 cycles. After treatment, 18F-FDG PET/CT showed a significant decrease in the size of the metastases, but he had a Grade 4 alanine aminotransferase (ALT) elevation. Liver histology revealed drug-induced liver damage. Therefore, we performed steroid half-pulse therapy followed by oral methylprednisolone, but his ALT level did not completely recover to the normal range even after five months. We herein report a case with specific, sustained liver injury induced by nivolumab as an immune-related adverse events.

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© 2018 by The Japanese Society of Internal Medicine
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