Progressive liver failure induced by everolimus for renal cell carcinoma in a 58-year-old male hepatitis B virus carrier.
Progressive liver failure induced by everolimus for renal cell carcinoma in a 58-year-old male hepatitis B virus carrier.
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DOI：
10.1007/s12328-013-0371-4
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发表时间：
2013-04
影响因子：
1
通讯作者：
Hibi, Toshifumi
中科院分区：
文献类型：
--
作者：
Mizuno, Shinta;Yamagishi, Yoshiyuki;Ebinuma, Hirotoshi;Nakamoto, Nobuhiro;Katahira, Mai;Sasaki, Aya;Sakamoto, Michiie;Suzuki, Hidekazu;Kanai, Takanori;Hibi, Toshifumi
大约 30 年前，一名 58 岁男子被诊断为乙型肝炎病毒 (HBV) 携带者。 57 岁时，他被诊断出患有肾细胞癌。进行了根治性肾切除术，并给予依维莫司治疗肺转移。开始使用依维莫司后，出现间歇性发烧、全身疲劳和黄疸。他因乙型肝炎病毒再激活而被诊断为慢性乙型肝炎急性发作（急性加重）而入院。尽管接受了重症监护，他还是死于肝功能衰竭和真菌感染。尸检结果与依维莫司重新激活 HBV 导致的肝衰竭相符。在乙型肝炎病毒携带者开始免疫抑制治疗（例如依维莫司）之前，必须考虑抗病毒预防。
A 58-year-old man was diagnosed as a hepatitis B virus (HBV) carrier approximately 30 years ago. He was diagnosed with renal cell carcinoma when he was 57 years old. Radical nephrectomy was performed, and everolimus was administered to treat his lung metastasis. After beginning the everolimus, intermittent fever, general fatigue, and jaundice developed. He was admitted under a diagnosis of flare (acute exacerbation) of chronic B hepatitis due to HBV reactivation. Despite intensive care, he died of hepatic failure and fungus infection. The autopsy findings were compatible with hepatic failure due to HBV reactivation by everolimus. Antiviral prophylaxis must be taken into consideration before beginning immunosuppressive therapy such as everolimus in HBV carriers.