Imatinib mesylate-induced acute hepatitis in a patient treated for gastrointestinal stromal tumour

Pariente, Alexandre; Etcharry, F; Cales, Valérie; Laborde, Y; Ferrari, S.; Biour, M

doi:10.1097/01.meg.0000216941.42306.0e

Cited by 28 publications

(15 citation statements)

References 12 publications

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“…Imatinib-induced hepatotoxicity histology may indicate focal necrosis with lymphocytic infiltration [12,14]; from marked periportal necrosis with mixed lymphocyte, neutrophil, and plasmocyte infiltration [18]; to massive hepatic necrosis or cytolytic acute hepatitis [13,15]. However, cases were reported with positive for anti liver citosol 1 and antinuclear antibodies, liver biopsies showed histological changes more suggestive of an autoimmune hepatitis [17,20].…”

Section: Discussionmentioning

confidence: 98%

Imatinib mesylate-induced acute liver failure in a patient with gastrointestinal stromal tumors

et al. 2009

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Imatinib mesylate is a drug that has been approved for treatment of chronic myeloid leukemia, Philadelphia-positive acute lymphoblastic leukemia, and advanced gastrointestinal stromal tumors. Several cases of hepatotoxicity, including fatal liver failure, have been reported with the long-term use of imatinib mesylate. Generally hepatotoxicity resolves after discontinuation of imatinib. Despite discontinuation of imatinib, hepatotoxicity can be progressive. Steroid may be useful in these patients and should be started early. We report a 53-year-old woman with advanced gastrointestinal stromal tumors who developed hepatotoxicity while receiving imatinib and subsequently acute liver failure. Ten weeks after commencing imatinib treatment, hepatotoxicity was determined. Imatinib was immediately ceased. Subsequently, a week later hepatic encephalopathy, jaundice, and coagulopathy occurred. Prednisolone was commenced. Liver biopsy was performed five weeks after the determining of hepatotoxicity. Biopsy showed sinusoidal congestion, necrosis of hepatocytes, inflammation, and hepatocyte drop out around the hepatic venule consistent with drug toxicity. Her liver function tests normalized with a nine-week prednisolone treatment. The patient was discharged. Her liver enzymes remained in normal range following visits. In cases of imatinib-induced acute hepatitis, the administration of prednisolone may be useful in the resolution of the acute episode and allow the reintroduction of a drug without risking recurrence of hepatitis.

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Section: Discussionmentioning

confidence: 98%

Imatinib mesylate-induced acute liver failure in a patient with gastrointestinal stromal tumors

et al. 2009

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“…29 In addition, reports of liver toxicity of imatinib have been published. [30][31][32][33][34][35] Liver toxicity usually occurs after more than 3 months of treatment, and drug interruption reverses the toxicity in the large majority of cases. The mechanisms of liver toxicity are unknown.…”

Section: Discussionmentioning

confidence: 99%

Serum ferritin as risk factor for sinusoidal obstruction syndrome of the liver in patients undergoing hematopoietic stem cell transplantation

Maradei

Maiolino

Azevedo

et al. 2009

Blood

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“…Most of them present with mild temporary liver enzyme elevations, which resolve after dose reductions or discontinuation of imatinib treatment [7,8]. However, acute liver failure has also been reported sporadically during imatinib treatment [9-11]. Histologic changes have been described in some of these cases and consist of inflammation, fatty degeneration, or necrosis of the liver [10,12,13].…”

Section: Discussionmentioning

confidence: 99%

Imatinib-induced liver cirrhosis in a patient with advanced gastrointestinal stroma tumor (GIST)

et al. 2012

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BackgroundThe use of imatinib mesylate is associated with a progression free survival of 41 months in first line treatment of metastatic or locally advanced gastrointestinal stromal tumors (GIST) and other studies approved that adjuvant imatinib treatment improves the recurrence-free survival in patients with GIST. Current recommendations include 1 year adjuvant treatment in GIST patients at risk but active studies explore different durations of treatment with an interval of up to 5 years. While the most frequent adverse events (AEs) are blood count alterations, abdominal discomfort and edema, the occurrence of grade 3 or 4 increase of AST or ALT is specified with 2.1% and 2.7% respectively.Case presentationWe report a 49-year old male with a gastrointestinal stromal tumor (GIST) of the small bowel who developed liver cirrhosis under adjuvant imatinib treatment.ConclusionsOur report supports the notion that imatinib-induced hepatotoxicity may lead to acute liver damage with subsequent cirrhotic remodelling. Patients developing grade 3 or 4 hepatotoxicity during imatinib treatment should therefore be carefully evaluated for chronic liver disease.

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Imatinib mesylate-induced acute hepatitis in a patient treated for gastrointestinal stromal tumour

Cited by 28 publications

References 12 publications

Imatinib mesylate-induced acute liver failure in a patient with gastrointestinal stromal tumors

Imatinib mesylate-induced acute liver failure in a patient with gastrointestinal stromal tumors

Serum ferritin as risk factor for sinusoidal obstruction syndrome of the liver in patients undergoing hematopoietic stem cell transplantation

Imatinib-induced liver cirrhosis in a patient with advanced gastrointestinal stroma tumor (GIST)

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