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。

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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引用次数: 0

摘要

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

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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来源期刊

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.