title: Progressive liver failure induced by everolimus for renal cell carcinoma in a 58-year-old male hepatitis B virus carrier.
abstract: A 58-year-old man was diagnosed as a hepatitis B virus (HBV) carrier approximately 30 years ago. He was diagnosed with renal cell carcinoma when he was 57 years old. Radical nephrectomy was performed, and everolimus was administered to treat his lung metastasis. After beginning the everolimus, intermittent fever, general fatigue, and jaundice developed. He was admitted under a diagnosis of flare (acute exacerbation) of chronic B hepatitis due to HBV reactivation. Despite intensive care, he died of hepatic failure and fungus infection. The autopsy findings were compatible with hepatic failure due to HBV reactivation by everolimus. Antiviral prophylaxis must be taken into consideration before beginning immunosuppressive therapy such as everolimus in HBV carriers.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, 160-8582 Japan.
authors.forename: Shinta
authors.initials: S
authors.lastname: Mizuno
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yamagishi
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ebinuma
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Nakamoto
authors.forename: Mai
authors.initials: M
authors.lastname: Katahira
authors.forename: Aya
authors.initials: A
authors.lastname: Sasaki
authors.forename: Michiie
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
keywords: Everolimus; Hepatitis B virus; Immunosuppressive therapy; Liver failure; Nucleoside analogue