Salvado M, Vargas V, Vidal M, Simon-Talero M, Camacho J, Gamez J. Autoimmune-like hepatitis during masitinib therapy in an amyotrophic lateral sclerosis patient. World J Gastroenterol 2015; 21(36): 10475-10479 [PMID: 26420975 DOI: 10.3748/wjg.v21.i36.10475]
Corresponding Author of This Article
Josep Gamez, MD, PhD, ALS Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Passeig Vall d'Hebron, 119, Barcelona, Spain. josepgamez.bcn@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Sep 28, 2015; 21(36): 10475-10479 Published online Sep 28, 2015. doi: 10.3748/wjg.v21.i36.10475
Autoimmune-like hepatitis during masitinib therapy in an amyotrophic lateral sclerosis patient
Maria Salvado, Victor Vargas, Marta Vidal, Macarena Simon-Talero, Jessica Camacho, Josep Gamez
Maria Salvado, Josep Gamez, ALS Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
Victor Vargas, Macarena Simon-Talero, Liver Unit, Department of Medicine, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
Marta Vidal, Jessica Camacho, Pathology Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron, Autonomous University of Barcelona, Barcelona, Spain
Author contributions: Salvado M contributed to acquisition of data, analysis and interpretation of data, drafting of the article; Vargas V contributed to analysis and interpretation of data, critical revision for important intellectual content; Simon-Talero M, Camacho J and Vidal M contributed to acquisition of data, analysis and interpretation of data; Gamez J contributed to study conception and design, analysis and interpretation of the data; drafting of the article; all authors have made the final approval of the version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the article are appropriately investigated and resolved.
Supported by Grants from the Spanish Fondo de Investigaciones Sanitarias no. PI13-01272 (to Gamez J); and an Interlaken Research Awards Program.
Conflict-of-interest statement: The authors who have taken part in this study declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Josep Gamez, MD, PhD, ALS Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Passeig Vall d'Hebron, 119, Barcelona, Spain. josepgamez.bcn@gmail.com
Telephone: +34-93-2746000 Fax: +34-93-2110912
Received: March 20, 2015 Peer-review started: March 20, 2015 First decision: April 23, 2015 Revised: May 7, 2015 Accepted: July 3, 2015 Article in press: July 3, 2015 Published online: September 28, 2015 Processing time: 192 Days and 11.6 Hours
Abstract
We report a case of acute severe hepatitis resulting from masitinib in a young amyotrophic lateral sclerosis patient. Hepatotoxicity induced by masitinib, a tyrosine kinase inhibitor, is usually transient with mild elevation of transaminases, although acute hepatitis has been not reported to date. The hepatitis was resolved after masitinib was discontinued and a combination of prednisone and azathioprine was started. The transaminases returned to baseline normal values five months later. This is the first case in the hepatitis literature associated with masitinib. The autoimmune role of this drug-induced liver injury is discussed. Physicians should be aware of this potential complication.
Core tip: Physicians must be aware of the possibility of drug-induced liver injury in clinical trials, despite the drug having been shown to be of limited hepatotoxicity when tested in phase I-II trials. We present an example of a patient resembling an autoimmune hepatitis. Despite discontinuing masitinib, the transaminases did not return to their baseline values for five months.
