Programmed cell death-1 inhibitor-related sclerosing cholangitis:A systematic review

作     者：Takumi Onoyama Yohei Takeda Taro Yamashita Wataru Hamamoto Yuri Sakamoto Hiroki Koda Soichiro Kawata Kazuya Matsumoto Hajime Isomoto 

作者机构：Division of Medicine and Clinical ScienceDepartment of Multidisciplinary Internal MedicineFaculty of MedicineTottori UniversityTottori prefecture 683-8504Japan Internal MedicineIrisawa Medical ClinicShimane prefecture 690-0025Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2020年第26卷第3期

页      面：353-365页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Nivolumab Pembrolizumab Avelumab Durvalumab Atezolizumab Programmed cell death-1 inhibitor Immune-related adverse events Cholangitis 

摘      要：BACKGROUND Programmed cell death-1(PD-1)inhibitor has been indicated for many types of ***,these inhibitors also cause immune-related adverse *** disorder is a phenotype of immune-related adverse event affecting 0%–4.5%of patients treated with PD-1 *** studies have reported PD-1 inhibitor-related sclerosing cholangitis(SC);however,the associated clinical and pathological features are *** To evaluate the clinical and pathological features of PD-1 inhibitor-related SC through a systematic review of the *** The review,conducted using electronic databases in PubMed,was restricted to the period from January 2014 to September 2019 and focused on case reports/series on PD-1 inhibitor-related SC published in *** scanned the references of the selected literature to identify any further relevant *** cases previously studied by us,including three that have not yet been published,were included in this *** Thirty-one PD-1 inhibitor-related SC cases were *** age of patients was 67 years(range,43–89),with a male to female ratio of 21:*** main disease requiring PD-1 inhibitor treatment was non-small cell lung *** that caused PD-1 inhibitor-related SC were nivolumab(19 cases),pembrolizumab(10 cases),avelumab(1 case),and durvalumab(1 case).The median number of cycles until PD-1 inhibitor-related SC onset was 5.5(range,1–27).Abdominal pain or discomfort(35.5%,11/31)was the most frequent *** serum tests identified liver dysfunction with a notable increase in biliary tract enzymes relative to hepatic enzymes,and a normal level of serum immunoglobulin *** dilation without obstruction(76.9%,20/26),diffuse hypertrophy of the extrahepatic biliary tract(90.5%,19/21),and multiple strictures of the intrahepatic biliary tract(30.4%,7/23)were *** 11/23(47.8%)cases,pathological examination indicated that CD8+T cells were the dominant inflammatory cells i