首例报告免疫相关不良事件导致重度出血

许多疾病都可表现为胆管异常，例如，免疫功能的紊乱或改变会严重影响胆管树。今天和大家分享国医院的病例，患者因口腔癌接受了抗免疫治疗，随后出现与免疫相关不良事件有关的出血性胆管炎，患者最终死亡。GIE高级副主编DouglasG.Adler对此病例发表了评论，引发思考。

Cholangioscopicfindingofseverehemorrhagiccholangitisassociatedwithimmune-relatedadverseevents

胆道镜检查发现免疫相关不良事件引起重度出血性胆管炎

作者：YusukeHashimoto,MD,KanaKumahara,MD,YuriUeda,MD,MakotoTahara,MD,PhD

作者机构：DepartmentofHepatobiliaryandPancreaticOncology,NationalCancerCenterHospitalEast,Kashiwa-shi,Chiba,Japan

A73-year-oldwomanwithoralcancerandlungmetastasisshowedelevatedliverenzymes(aspartateaminotransferase,U/L;alanineaminotransferase,U/L;alkalinephosphatase,U/L;andtotalbilirubin,0.9mg/dL)after5cyclesofanti-PD-1therapy.CTshoweddiffusethickeningoftheintra-andextrahepaticbileducts.ERCPrevealedanirregularcontrastdefectinthe

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