Immune Netw.  2012 Jun;12(3):126-128. 10.4110/in.2012.12.3.126.

A Case of Drug-Induced Hepatitis due to Bortezomib in Multiple Myeloma

• Kim Y
• Kim KY
• Lee SH
• Chung YY
• Yahng SA
• Lee SE
• Park G
• Min CK

• KMID: 2168011
• DOI: http://doi.org/10.4110/in.2012.12.3.126

Abstract

We report on a case of severe hepatotoxicity in a 52-year-old male with multiple myeloma (MM) who had received bortezomib therapy. At patient presentation, liver enzymes were normal, but started to markedly increase 3 days after the patient's second dose of bortezomib was administered, when free kappa light chains were noticeably reduced in the serum. After discontinuation of bortezomib, liver enzymes recovered gradually to baseline. Then, the patient was started on a thalidomide-containing regimen, which he was able to tolerate well. The patient achieved complete remission prior to autologous stem cell transplantation (ASCT). The patient underwent ASCT without occurrence of further liver toxicity.

Keyword

Bortezomib; Hepatotoxicity; Multiple myeloma

MeSH Terms

Boronic Acids
Bortezomib
Drug-Induced Liver Injury
Humans
Light
Liver
Male
Middle Aged
Multiple Myeloma
Pyrazines
Stem Cell Transplantation
Boronic Acids
Pyrazines

Figure

• 

  Figure 1 Histological view (hematoxylin-eosin stain, original marnification ×200) showing minimal portoperiportal activity without fibrotic change (left) and severe lobular activity.

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  Figure 2 Graphic illustration of liver function test alterations following bortezomib exposure. ASAT, Aspatate aminotransferase; ALAT, alanineaminotransferase; GGT, gamma-glutamyl transferase; AP, alkaline phosphatase.

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