{
    "abstract": "A woman in her 50s presented to the hospital with new-onset jaundice and ascites. Her medical history included a melanoma of the right shoulder, diagnosed 8 months before, for which she had received four cycles of ipilimumab and nivolumab. Due to the oncological history and previous immunotherapy, an immune-checkpoint-inhibitor (ICI)-induced hepatitis was suspected, and a high-dose corticosteroid treatment was initiated. However, as there was no improvement in the liver function tests, a percutaneous liver biopsy was performed for further diagnostic clarification. Histological analysis ultimately identified a hepatic sinusoidal obstruction syndrome (SOS) as the underlying cause of liver dysfunction and portal hypertension. ICI-related hepatic SOS represents an extremely rare adverse event related to immunotherapy that should be considered in all patients with treatment-refractory ICI-related hepatotoxicity and clinical signs of portal hypertension.",
    "authors": [
        {
            "affiliation": "Department of Gastroenterology and Hepatology, University Hospital Cologne, Cologne, North Rhine-Westphalia, Germany philipp.kasper@uk-koeln.de.",
            "firstname": "Philipp",
            "initials": "P",
            "lastname": "Kasper"
        },
        {
            "affiliation": "Department of Pathology, University Hospital Cologne, Cologne, North Rhine-Westphalia, Germany.",
            "firstname": "Anne Kristin",
            "initials": "AK",
            "lastname": "Fischer"
        },
        {
            "affiliation": "Department of Gastroenterology and Hepatology, University Hospital Cologne, Cologne, North Rhine-Westphalia, Germany.",
            "firstname": "Jan Christoph",
            "initials": "JC",
            "lastname": "Schumacher"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.",
    "doi": "10.1136/bcr-2024-260066",
    "journal": "BMJ case reports",
    "keywords": [
        "Gastroenterology",
        "Gastrointestinal system",
        "Immunological products and vaccines",
        "Liver disease",
        "Portal hypertension"
    ],
    "methods": null,
    "publication_date": "2024-10-01",
    "pubmed_id": "39349302",
    "results": null,
    "title": "Hepatic sinusoidal obstruction syndrome after immune-checkpoint-inhibitor therapy: when the liver sends SOS.",
    "xml": "<Element 'PubmedArticle' at 0x788502821210>"
}