title: Successful treatment of erlotinib-induced acute hepatitis and acute interstitial pneumonitis with high-dose corticosteroid: a case report and literature review.
abstract: Erlotinib, a kind of epidermal growth factor receptor tyrosine kinase inhibitor, is a target therapy and approved for the treatment of metastatic non-small cell lung cancer (NSCLC) and advanced pancreatic cancer. Among these EGFR-TKI agents, including gefitinib and erlotinib, the common dose-limiting toxicities are diarrhea, mucositis and skin rash (Acneform eruptions). In addition to the above adverse effects, infrequent but potentially fatal and lethal entity complications include acute interstitial lung disease (ILD) and acute hepatitis. The incidence of EGFR-TKI agents (gefitinib and erlotinib) induced acute hepatitis is rare and hepatotoxicity of EGFR-TKI agent was rarely discussed. The treatment of EGFR-TKI agents induced acute hepatitis remains uncertain and cessation medication is current policy. Here we reported a case of erlotinib induced interstitial pneumonitis and acute hepatitis with clinical appearance of hypoxemia and general weakness, treated with high dose pulse therapy and showed good recovery.
authors: Department of Medicine, National Yang-Ming University Hospital, Yilan, Taiwan, China.
authors: Y-C
authors: YC
authors: Lai
authors: P-C
authors: PC
authors: Lin
authors: J-I
authors: JI
authors: Lai
authors: S-Y
authors: SY
authors: Hsu
authors: L-C
authors: LC
authors: Kuo
authors: S-C
authors: SC
authors: Chang
authors: W-S
authors: WS
authors: Wang
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury / Q000000981:diagnostic imaging / Q000188:drug therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D000069347:Erlotinib Hydrochloride; D006801:Humans; D008111:Liver Function Tests; D017563:Lung Diseases, Interstitial / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D018908:Muscle Weakness / Q000139:chemically induced / Q000453:epidemiology; D011799:Quinazolines / Q000009:adverse effects* / Q000627:therapeutic use; D013902:Radiography, Thoracic
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; C512478:EGFR protein, human; D066246:ErbB Receptors; D008775:Methylprednisolone