Fulminant hepatitis in a hepatitis B surface antigen-positive patient with adult T-cell leukemia-lymphoma after mogamulizumab monotherapy.
Takahiro NakashimaShigeru KusumotoTakashi IshidaChie KatoShinya HagiwaraTomoko NaritaAyako MasakiAsahi ItoMasaki RiHirokazu KomatsuHiroshi InagakiYasuhito TanakaShinsuke IidaPublished in: Hepatology research : the official journal of the Japan Society of Hepatology (2024)
We report a case of fulminant hepatitis in a hepatitis B surface antigen (HBsAg)-positive patient with aggressive adult T-cell leukemia-lymphoma who received monotherapy with an anti-CCR4 monoclonal antibody, mogamulizumab, with decreased hepatitis B virus (HBV)- DNA levels by entecavir prophylaxis. Although HBV reactivation-related hepatitis was considered in the differential diagnosis, the patient did not meet the conventional criteria for HBV reactivation and was finally diagnosed with drug-induced hepatitis. Considering that the immunoenhancing effects of mogamulizumab can lead to HBV reactivation-related hepatitis in HBsAg-positive patients, we should differentiate drug-induced hepatitis from HBV reactivation, especially in patients receiving immunomodulatory drugs, if HBV-DNA levels are reduced by antiviral prophylaxis.
Keyphrases
- hepatitis b virus
- drug induced
- liver injury
- liver failure
- case report
- monoclonal antibody
- end stage renal disease
- acute myeloid leukemia
- diffuse large b cell lymphoma
- bone marrow
- ejection fraction
- newly diagnosed
- single molecule
- chronic kidney disease
- randomized controlled trial
- open label
- circulating tumor
- cell free
- peritoneal dialysis
- adverse drug
- patient reported outcomes
- study protocol
- double blind
- childhood cancer