Evans' syndrome induced by atezolizumab plus bevacizumab combination therapy in advanced hepatocellular carcinoma.
Atezolizumab
Evans’ syndrome
Hepatocellular carcinoma
Immune-related adverse event
Journal
Clinical journal of gastroenterology
ISSN: 1865-7265
Titre abrégé: Clin J Gastroenterol
Pays: Japan
ID NLM: 101477246
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
26
10
2022
accepted:
30
01
2023
medline:
22
5
2023
pubmed:
7
2
2023
entrez:
6
2
2023
Statut:
ppublish
Résumé
An 86-year-old man presented with recurrence of hepatocellular carcinoma (HCC) after surgery. Atezolizumab plus bevacizumab was initiated. After the third course of atezolizumab plus bevacizumab therapy, petechial purpura appeared on the extremities and trunk. Laboratory tests revealed isolated severe thrombocytopenia without evidence of combined coagulopathy. He was diagnosed with immune thrombocytopenic purpura (ITP), and high-dose immunoglobulin and Helicobacter pylori eradication therapies were administered. Improvement in thrombocytopenia was observed; however, 20 days after the onset of ITP, laboratory data revealed hemolytic anemia. Both direct and indirect Coombs tests were positive, and he was diagnosed with Evan's syndrome complicated by ITP and autoimmune hemolytic anemia (AIHA) induced by immune-related adverse events (irAEs). After treatment with prednisolone, the hemoglobin level increased, and hemolytic findings improved on blood tests. We encountered a rare case of Evans' syndrome due to atezolizumab plus bevacizumab therapy for HCC. In atezolizumab plus bevacizumab therapy, hematologic toxicities are not rare adverse events and attention is required.
Identifiants
pubmed: 36746879
doi: 10.1007/s12328-023-01767-0
pii: 10.1007/s12328-023-01767-0
doi:
Substances chimiques
Bevacizumab
2S9ZZM9Q9V
atezolizumab
52CMI0WC3Y
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
402-406Informations de copyright
© 2023. Japanese Society of Gastroenterology.
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