Liver injury induced by mepolizumab in treatment of eosinophilic granulomatosis with polyangiitis: a case report
10.12025/j.issn.1008-6358.2025.20250475
- VernacularTitle:美泊利珠单抗治疗嗜酸性肉芽肿性血管炎致肝损伤1例报告
- Author:
Yaqian LI
1
;
Xiaoyu LI
2
;
Meiling JIN
3
;
Xiaofen YE
2
Author Information
1. Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai 200032, China;Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China.
2. Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
3. Department of Allergy, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
- Publication Type:Clinicalcaseanalysis
- Keywords:
mepolizumab;
eosinophilic granulomatosis with polyangiitis;
drug-induced liver injury;
adverse drug reaction
- From:
Chinese Journal of Clinical Medicine
2025;32(5):885-890
- CountryChina
- Language:Chinese
-
Abstract:
A 52-year-old female patient was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA), asthma and allergic rhinitis and was treated with mepolizumab (100 mg, once every 4 weeks). Three days after the second administration, the patient developed dark yellow urine, and abnormal liver function indicators were found on day 6 after administration. Laboratory tests showed total bilirubin (TBIL) of 22 μmol/L, direct bilirubin (DBIL) of 14.9 μmol/L, alanine aminotransferase (ALT) of 461 U/L, aspartate aminotransferase (AST) of 129 U/L, and alkaline phosphatase (ALP) of 296 U/L. After a comprehensive assessment, it was considered that mepolizumab may caused liver injury in the patient. Magnesium isoglycyrrhizinate, glutathione, and ursodeoxycholic acid were used for liver protection. Five days later, the urine color became lighter and liver function indicators improved (TBIL 17.4 μmol/L, DBIL 9.8 μmol/L, ALT 214 U/L, AST 85 U/L, ALP 226 U/L). After about 2 weeks of continued liver protection treatment, liver function returned to normal. Mepolizumab treatment was suspended and during the follow-up for about half a year, the patient did not experience liver function abnormalities or other discomforts again.
