Imatinib-induced immune hepatitis: case report and literature review.
Imatinib is one of the most recent medications used for the treatment of chronic myeloid leukemia (CML) and gastrointestinal stromal tumor (GIST). It is an orally administered protein-tyrosine kinase inhibitor, an enzyme which is produced by BCR-ABL fusion which results from translocation of 9:22 chromosome (Philadelphia chromosome). Imatinib blocks proliferation and induces apoptosis of BCR-ABL-expression in CML. Many side effects produced by imatinib have been documented but its induction of hepatotoxcity has been rarely reported. Only a few cases so far have been reported in the literature and almost all were in females. We describe another case of hepatotoxicity due to imatinib in a 17-year old female with clinical, laboratory and histopathological changes. The case described here suggests that imatinib may also induce immune hepatitis, in some patients.
Al Sobhi
Enaam
E
Department of Pathology and Laboratory Medicine, King Khalid National Guard Hospital, Jeddah, Saudi Arabia. ensobhi@hotmail.com
Zahrani
Zayed
Z
Zevallos
Eduardo
E
Zuraiki
Abdo
A
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D000974:Antibodies, Antinuclear / Q000097:blood; D000918:Antibody Specificity; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D001549:Benzamides; D004247:DNA / Q000276:immunology; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D041781:Jaundice, Obstructive / Q000139:chemically induced; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy; D015466:Leukemia, Myeloid, Chronic-Phase / Q000150:complications / Q000188:drug therapy; D009130:Muscle, Smooth / Q000276:immunology; D010879:Piperazines / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use
D000974:Antibodies, Antinuclear; D000970:Antineoplastic Agents; D001323:Autoantibodies; D001324:Autoantigens; D001549:Benzamides; D007166:Immunosuppressive Agents; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D004247:DNA; D011239:Prednisolone; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase