Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2021; 9(16): 4110-4115
Published online Jun 6, 2021. doi: 10.12998/wjcc.v9.i16.4110
Atezolizumab-induced anaphylactic shock in a patient with hepatocellular carcinoma undergoing immunotherapy: A case report
Li-Fang Bian, Chao Zheng, Xiao-Lan Shi
Li-Fang Bian, Xiao-Lan Shi, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Chao Zheng, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Author contributions: Bian LF and Zheng C contributed equally to this work; Bian LF was the patient’s nurse, reviewed the literature, and contributed to manuscript drafting; Zheng C reviewed the literature, interpreted the imaging findings, and contributed to manuscript drafting; Shi XL contributed to manuscript drafting; all authors issued final approval for the version to be submitted.
Supported by Medical Health Science and Technology Project of Zhejiang Provincial Health Commission, China, No. 2020372769.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and accompanying images and clinical data.
Conflict-of-interest statement: There is no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Fang Bian, MSN, Associate Chief Nurse, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qing Chun Road, Hangzhou 310003, Zhejiang Province, China. doggie_cc@zju.edu.cn
Received: January 31, 2021
Peer-review started: January 31, 2021
First decision: March 15, 2021
Revised: March 16, 2021
Accepted: March 24, 2021
Article in press: March 24, 2021
Published online: June 6, 2021
Processing time: 102 Days and 21.5 Hours
Core Tip

Core Tip: Treatment with immune checkpoint inhibitors (ICIs) can lead to hypersensitivity reactions; however, anaphylactic shock is rare. We present a case of life-threatening anaphylactic shock during atezolizumab infusion and performed a relevant literature review. Patients may be allergic to drugs targeting both programmed death-1 (PD-1) and programmed death ligand 1 (PD-L1). Adequate attention should be paid to the related complications in the use of immune checkpoint inhibitors. Nevertheless, further studies are needed to understand the underlying mechanisms of hypersensitivity reactions and establish standardized skin test and desensitization protocols associated with PD-1 and PD-L1 to ensure effective treatment with ICIs.