title: Immunosuppressant therapy successfully improved regorafenib-induced severe hepatic injury in a patient with metastatic gastrointestinal stromal tumor: A case report.
abstract: A 75-year-old man diagnosed with ileal gastrointestinal tumor with peritoneal dissemination was subjected to salvage treatment with regorafenib at 120 mg/day. Following the initiation of the treatment, liver dysfunction appeared on day 28, and continued to worsen despite termination of the treatment. Since no increase in the levels of serum immunoglobulins of the patient was observed, and negative results were obtained for the analysis of viral markers and autoantibodies, a diagnosis of regorafenib-induced hepatitis was suggested. In consequence, the patient received steroid pulse therapy and continuous administration of prednisolone, without sufficient improvement. Liver biopsy revealed interface hepatitis with prominent plasma cell infiltration, suggesting regorafenib-induced autoimmune hepatitis. The patient was then administered azathioprine and prednisolone, which improved the hepatic injury. The present case represents the first report of successful treatment of regorafenib-induced severe hepatic injury by the use of an immunosuppressant.
authors: Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan.
authors: Miyuki
authors: M
authors: Kuwayama
authors: Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan.
authors: Keita
authors: K
authors: Uchino
authors: Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan; Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan.
authors: Kotoe
authors: K
authors: Takayoshi
authors: Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan.
authors: Masato
authors: M
authors: Komoda
authors: Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan.
authors: Motoyuki
authors: M
authors: Kohjima
authors: Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan.
authors: Makoto
authors: M
authors: Nakamuta
authors: Department of Pathology, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan.
authors: Seiya
authors: S
authors: Momosaki
authors: Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan.
authors: Hitoshi
authors: H
authors: Kusaba
authors: Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan.
authors: Koichi
authors: K
authors: Akashi
authors: Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
authors: Eishi
authors: E
authors: Baba
keywords: drug-induced autoimmune hepatitis; gastrointestinal stromal tumor; immunosuppressant; liver injury; regorafenib