Yeungnam Univ J Med.  2019 May;36(2):155-158. 10.12701/yujm.2019.00115.

Imatinib-induced hepatitis treated by corticosteroids in a patient with metastatic gastrointestinal stromal tumor

• Kang MK
• Lee HJ
• Choi JH

• KMID: 2449330
• DOI: http://doi.org/10.12701/yujm.2019.00115

Abstract

Imatinib mesylate is currently used as the first-line treatment for metastatic gastrointestinal stromal tumors (GISTs). Imatinib-induced hepatotoxicity in patients with GIST is very rare. Its features vary from subclinical elevation of serum aminotransferase to clinically apparent acute hepatitis, which is associated with immunologic reactions. Imatinib-induced hepatotoxicity with autoimmune-like features can be treated by the discontinuation of imatinib mesylate and the administration of oral steroids. Here, we report a case of late-onset imatinib-induced hepatitis with autoimmune-like features in a patient with metastatic GIST, which was improved by oral corticosteroids.

Keyword

Corticosteroids; Drug-induced liver injury; Gastrointestinal stromal tumors; Imatinib mesylate

MeSH Terms

Adrenal Cortex Hormones*
Drug-Induced Liver Injury
Gastrointestinal Stromal Tumors*
Hepatitis*
Humans
Imatinib Mesylate
Steroids
Adrenal Cortex Hormones
Imatinib Mesylate
Steroids

Figure

• 

  Fig. 1. Abdominal computed tomography reveals no evidence of recurrence of GIST from upper abdomen (A) to lower abdomen (B) after segmental resection of small bowel and peritonectomy for metastatic GIST. GIST, gastrointestinal stromal tumor.

• 

  Fig. 2. Histological findings of the liver. (A) There is interface hepatitis with inflammatory cells infiltrations of lymphocytes and plasma cells (arrows) in portal and periportal area (hematoxylin and eosin stain, ×100). (B) The centrilobular necrosis is present, with golden-brown colored ceroid pigment-laden Kupffer cells (arrows) and shrunken, eosinophilic apoptotic hepatocytes (arrow head) (hematoxylin and eosin stain, ×200).

• 

  Fig. 3. Clinical course of the patient. ALT, alanine aminotransferase.

Reference

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