Severe Lenalidomide-Associated Hyperbilirubinemia

被引：1
|
作者：
Gildea, Daniel T. [1 ]
Roswarski, Joseph L. [2 ]
机构：
[1] MedStar Georgetown Univ Hosp, Internal Med, Washington, DC 20007 USA
[2] MedStar Georgetown Univ Hosp, Hematol & Oncol, Washington, DC USA
来源：
CUREUS JOURNAL OF MEDICAL SCIENCE | 2023年 / 15卷 / 01期
关键词：
oncology; treatment related toxicity; cholestatic liver injury; extra-medullary plasmacytoma; immunomodulatory imide drugs; direct hyperbilirubinemia; hepatology; MYELOMA;
D O I：
10.7759/cureus.34408
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Immunomodulatory drugs (IMids), such as thalidomide and lenalidomide, are used to treat plasma cell neoplasms and B-cell malignancies. We present a case of severe direct hyperbilirubinemia in a patient taking lenalidomide-based therapy for plasmacytoma. Imaging was unrevealing, and liver biopsy showed only mild sinusoidal dilation. Roussel Uclaf Causality Assessment (RUCAM) score was 6, indicating lenalidomide was a probable cause of the injury. To our knowledge, this is the highest reported direct bilirubin regarding lenalidomide drug-induced liver injury (DILI), with a peak bilirubin of 41mg/dL. While a clear pathophysiology was not identified, this case provides important considerations regarding lenalidomide safety.
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页数：3
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