Clinical pharmacist participated in a case study of a severe immune-related cholestatic liver injury case induced by camrelizumab
10.12173/j.issn.1005-0698.202410130
- VernacularTitle:临床药师参与1例卡瑞利珠单抗致严重免疫相关胆汁淤积型肝损伤病例分析
- Author:
Lixia YUWEN
1
;
Yunhao HE
1
;
Yaohui YUAN
1
Author Information
1. 邢台市中心医院药剂科(河北 邢台 054000)
- Publication Type:Journal Article
- Keywords:
Clinical pharmacist;
Camrelizumab;
Liver injury;
Cholestatic;
Immunotherapy
- From:
Chinese Journal of Pharmacoepidemiology
2025;34(3):341-345
- CountryChina
- Language:Chinese
-
Abstract:
One case of non-small cell lung adenocarcinoma patient developed severe liver injury(ALT 319.6 U·L-1,AST 103.3 U·L-1,ALP 586.8 U·L-1,DBIL 104.0 μmol·L-1,TBIL 172.3 μmol·L-1,IBIL 68.3 μmol·L-1),after multiple cycles of chemotherapy combined with camrelizumab.Subsequently,fever and jaundice on the face and sclera were noticed.Based on the previous medication,the RUCAM scale and the R value was used to evaluated the symptons,suggested a high likelihood of drug-induced cholestatic liver injury caused by camrelizumab.Clinical pharmacist proposed drug therapy recommendations for liver injury treatment and the selection of protective drugs.The physician adopted some of these therapeutic suggestions,and the patient was treated with methylprednisolone and hepatoprotective drugs.Although there was a temporary improvement in transaminase levels,bilirubin levels continued to rise.Later,the patient asked to discharge and passed away at home.Immune-related cholestatic liver injury caused by camrelizumab is insensitive to glucocorticoid therapy,clinicians should promptly consider adding immunosuppressants to enhance prognosis.Literature studies have shown that dual-molecule plasma adsorption system sequential plasma exchange has a certain therapeutic effect on immune-related cholestatic liver injury.
