Editorial
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2022; 14(7): 1269-1276
Published online Jul 27, 2022. doi: 10.4254/wjh.v14.i7.1269
Checkpoint inhibitor-induced hepatotoxicity: Role of liver biopsy and management approach
Fernando Bessone, Einar Stefan Bjornsson
Fernando Bessone, Department of Gastroenterology and Hepatology, Facultad de Ciencias Médicas, Hospital Provincial del Centenario, University of Rosario School of Medicine, Rosario 2000, Santa Fe, Argentina
Einar Stefan Bjornsson, Department of Gastroenterology, Natl Univ Hosp Iceland, Sect Gastroenterol & Hepatol, Dept Internal Med, Hringbraut 11D, IS-101 Reykjavik, Iceland
Einar Stefan Bjornsson, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik Postal code 101, State of Reykjavik, Iceland
Author contributions: Bessone F and Bjornsson ES contributed to this paper; Bessone F designed the overall concept and outline of the manuscript; Bjornsson ES contributed to the discussion and design of the manuscript; They both contributed to the writing, and editing the manuscript and review of literature.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fernando Bessone, MD, Full Professor, Department of Gastroenterology and Hepatology, Facultad de Ciencias Médicas, Hospital Provincial del Centenario, University of Rosario School of Medicine, Urquiza 3101, Rosario 2000, Santa Fe, Argentina. bessonefernando@gmail.com
Received: February 3, 2022
Peer-review started: February 3, 2022
First decision: April 8, 2022
Revised: April 13, 2022
Accepted: June 13, 2022
Article in press: June 13, 2022
Published online: July 27, 2022
Processing time: 173 Days and 17.4 Hours
Core Tip

Core Tip: Liver injury associated with immunological checkpoint inhibitors (ICIs) has been reported in 3%-8% of patients with grade III-IV hepatitis in retrospective studies. Although there are no distinctive histological features, the finding of granulomas and endothelitis may suggest a specific type of hepatitis induced by ICIs. Recent studies have demonstrated that 33-50% of patients improve spontaneously with discontinuation of ICIs. The high doses of corticosteroids with 1-2 mg/kg/d of methylprednisolone recommended by the oncological societies are controversial. Patients with ICI induced hepatoxicity without jaundice and/or coagulopathy should be monitored.