Hepatic sinusoidal obstruction syndrome (SOS) associated with checkpoint inhibitor therapy
Sinusoidal obstruction syndrome (SOS) is a distinctive and potentially fatal form of hepatic injury that mainly occurs after hematopoietic-stem cell transplantation but also due to many other conditions including drug or toxin exposure. Recently, immune checkpoint inhibitors (ICIs) have revolutionis...
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| Format: | Article |
| Language: | English |
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SMC MEDIA SRL
2024-12-01
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| Series: | European Journal of Case Reports in Internal Medicine |
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| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/4885 |
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| author | Marianna Litterio Nicole Marchetti Francesco Carubbi Marianna Tudini Luciano Mutti Claudio Ferri |
| author_facet | Marianna Litterio Nicole Marchetti Francesco Carubbi Marianna Tudini Luciano Mutti Claudio Ferri |
| author_sort | Marianna Litterio |
| collection | DOAJ |
| description | Sinusoidal obstruction syndrome (SOS) is a distinctive and potentially fatal form of hepatic injury that mainly occurs after hematopoietic-stem cell transplantation but also due to many other conditions including drug or toxin exposure. Recently, immune checkpoint inhibitors (ICIs) have revolutionised the treatment of many solid organ malignancies. Furthermore, as their use has become more widespread, rare toxicities have emerged. The difficulty lies in diagnosing these unusual toxicities with an incidence of as low as less than 1% hence defined as SOS. The development of the disease can be rapid and unpredictable. The severe forms of SOS may result in multi-organ dysfunction with a high mortality rate (>80%).
We present the case of a patient with metastatic lung adenocarcinoma treated with the ICI pembrolizumab who developed SOS with marked portal hypertension as a rare severe, toxic side effect of immunotherapy. This report highlights the importance of considering SOS in patients who develop liver dysfunction and/or portal hypertension during or after immunotherapy for neoplastic disease. Early identification and severity assessment is crucial in facilitating prompt diagnosis and timely treatment, improving the prognosis of our patients. |
| format | Article |
| id | doaj-art-d29f08291407454cb2493b3ae5a82182 |
| institution | Kabale University |
| issn | 2284-2594 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj-art-d29f08291407454cb2493b3ae5a821822025-01-07T13:40:28ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942024-12-0110.12890/2024_0048854420Hepatic sinusoidal obstruction syndrome (SOS) associated with checkpoint inhibitor therapyMarianna Litterio0Nicole Marchetti1Francesco Carubbi2Marianna Tudini3Luciano Mutti4Claudio Ferri5Department of Life, Health & Environmental Sciences, University of L’Aquila, L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, ItalyDepartment of Life, Health & Environmental Sciences, University of L’Aquila, L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy; Center of Biotechnology, College of Science and Technology, Temple University, SHRO, Philadelphia, USA; Italian Group for Mesothelioma, ItalyDepartment of Life, Health & Environmental Sciences, University of L’Aquila, L’Aquila, ItalySinusoidal obstruction syndrome (SOS) is a distinctive and potentially fatal form of hepatic injury that mainly occurs after hematopoietic-stem cell transplantation but also due to many other conditions including drug or toxin exposure. Recently, immune checkpoint inhibitors (ICIs) have revolutionised the treatment of many solid organ malignancies. Furthermore, as their use has become more widespread, rare toxicities have emerged. The difficulty lies in diagnosing these unusual toxicities with an incidence of as low as less than 1% hence defined as SOS. The development of the disease can be rapid and unpredictable. The severe forms of SOS may result in multi-organ dysfunction with a high mortality rate (>80%). We present the case of a patient with metastatic lung adenocarcinoma treated with the ICI pembrolizumab who developed SOS with marked portal hypertension as a rare severe, toxic side effect of immunotherapy. This report highlights the importance of considering SOS in patients who develop liver dysfunction and/or portal hypertension during or after immunotherapy for neoplastic disease. Early identification and severity assessment is crucial in facilitating prompt diagnosis and timely treatment, improving the prognosis of our patients.https://www.ejcrim.com/index.php/EJCRIM/article/view/4885sinusoidal obstruction syndromesospembrolizumabimmune checkpoint inhibitors |
| spellingShingle | Marianna Litterio Nicole Marchetti Francesco Carubbi Marianna Tudini Luciano Mutti Claudio Ferri Hepatic sinusoidal obstruction syndrome (SOS) associated with checkpoint inhibitor therapy European Journal of Case Reports in Internal Medicine sinusoidal obstruction syndrome sos pembrolizumab immune checkpoint inhibitors |
| title | Hepatic sinusoidal obstruction syndrome (SOS) associated with checkpoint inhibitor therapy |
| title_full | Hepatic sinusoidal obstruction syndrome (SOS) associated with checkpoint inhibitor therapy |
| title_fullStr | Hepatic sinusoidal obstruction syndrome (SOS) associated with checkpoint inhibitor therapy |
| title_full_unstemmed | Hepatic sinusoidal obstruction syndrome (SOS) associated with checkpoint inhibitor therapy |
| title_short | Hepatic sinusoidal obstruction syndrome (SOS) associated with checkpoint inhibitor therapy |
| title_sort | hepatic sinusoidal obstruction syndrome sos associated with checkpoint inhibitor therapy |
| topic | sinusoidal obstruction syndrome sos pembrolizumab immune checkpoint inhibitors |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/4885 |
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