Fulminant hepatitis in a hepatitis B surface antigen-positive patient with adult T-cell leukemia-lymphoma after mogamulizumab monotherapy

IF 3.9 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Hepatology Research Pub Date : 2024-05-21 DOI:10.1111/hepr.14057
Takahiro Nakashima, Shigeru Kusumoto, Takashi Ishida, Chie Kato, Shinya Hagiwara, Tomoko Narita, Ayako Masaki, Asahi Ito, Masaki Ri, Hirokazu Komatsu, Hiroshi Inagaki, Yasuhito Tanaka, Shinsuke Iida
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Abstract

We report a case of fulminant hepatitis in a hepatitis B surface antigen (HBsAg)-positive patient with aggressive adult T-cell leukemia-lymphoma who received monotherapy with an anti-CCR4 monoclonal antibody, mogamulizumab, with decreased hepatitis B virus (HBV)- DNA levels by entecavir prophylaxis. Although HBV reactivation-related hepatitis was considered in the differential diagnosis, the patient did not meet the conventional criteria for HBV reactivation and was finally diagnosed with drug-induced hepatitis. Considering that the immunoenhancing effects of mogamulizumab can lead to HBV reactivation-related hepatitis in HBsAg-positive patients, we should differentiate drug-induced hepatitis from HBV reactivation, especially in patients receiving immunomodulatory drugs, if HBV-DNA levels are reduced by antiviral prophylaxis.

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一名乙型肝炎表面抗原阳性的成人 T 细胞白血病-淋巴瘤患者接受莫干单抗单药治疗后出现暴发性肝炎。
我们报告了一例乙型肝炎表面抗原(HBsAg)阳性的侵袭性成人T细胞白血病-淋巴瘤患者的暴发性肝炎病例,该患者接受了抗CCR4单克隆抗体莫干单抗的单药治疗,并通过恩替卡韦预防降低了乙型肝炎病毒(HBV)- DNA水平。虽然在鉴别诊断中考虑了与 HBV 再激活相关的肝炎,但患者不符合 HBV 再激活的常规标准,最终被诊断为药物性肝炎。考虑到莫干珠单抗的免疫增强作用可导致 HBsAg 阳性患者出现 HBV 再激活相关性肝炎,我们应该将药物性肝炎与 HBV 再激活区分开来,尤其是在接受免疫调节药物治疗的患者中,如果 HBV-DNA 水平因抗病毒预防而降低的话。
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来源期刊
Hepatology Research
Hepatology Research 医学-胃肠肝病学
CiteScore
8.30
自引率
14.30%
发文量
124
审稿时长
1 months
期刊介绍: Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.
期刊最新文献
Issue Information Issue Information Expression patterns of hepatic Mac2-BP in the liver microenvironment Recent advances in systemic therapies for unresectable hepatocellular carcinoma and their impact on clinical outcomes Hepatolithiasis pathogenesis update
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