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Selected Publications
2021
1.
Atallah, Edmond; Wijayasiri, Pramudi; Cianci, Nicole; Abdullah, Khorrum; Mukherjee, Abhik; Aithal, Guruprasad P
Zanubrutinib-induced liver injury: a case report and literature review Journal Article
In: BMC Gastroenterol., vol. 21, no. 1, pp. 244, 2021.
Abstract | Tags: Case report, Drug-induced liver injury, hepatotoxicity, RUCAM, Zanubrutinib
@article{Atallah2021-ru,
title = {Zanubrutinib-induced liver injury: a case report and literature
review},
author = {Edmond Atallah and Pramudi Wijayasiri and Nicole Cianci and Khorrum Abdullah and Abhik Mukherjee and Guruprasad P Aithal},
year = {2021},
date = {2021-05-01},
journal = {BMC Gastroenterol.},
volume = {21},
number = {1},
pages = {244},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Zanubrutinib is a Bruton's tyrosine kinase inhibitor
that has been recently licensed in refractory mantle cell
lymphoma and under assessment in phase 3 clinical trials for
other B cell malignancies. To date, there are no reported cases
of hepatotoxicity secondary to zanubrutinib. We report the first
case of severe liver injury due to zanubrutinib. CASE
PRESENTATION: A 56-year-old Caucasian male with a history of
relapsed lymphoplasmacytic lymphoma was admitted to the hospital
with new-onset jaundice, choluria, and pruritus for 10 days. He
had been on zanubrutinib as part of a clinical trial for 30
months. His blood profile showed a severe hepatocellular injury
with jaundice (alanine transaminase 2474 IU/L and total
bilirubin 141 umol/L with mild coagulopathy). He had an
extensive work-up including virology, autoimmune, and metabolic
profiles in addition to abdominal ultrasound with no alternative
explanation found for his liver injury. Zanubrutinib-induced
liver injury was suspected, and causality assessment by the
updated Roussel Uclaf Causality Assessment Method score showed a
probable causal relationship with zanubrutinib. His liver
histology was also consistent with drug-induced liver injury.
His liver biochemistry improved following cessation of
zanubrutinib and normalised after 8 weeks. CONCLUSION: We report
the first case of severe liver injury secondary to zanubrutinib
after 30 months of treatment. This case raises clinical
awareness regarding zanubrutinib-induced liver toxicity and the
importance of drug withdrawal in the event of liver injury.},
keywords = {Case report, Drug-induced liver injury, hepatotoxicity, RUCAM, Zanubrutinib},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Zanubrutinib is a Bruton's tyrosine kinase inhibitor
that has been recently licensed in refractory mantle cell
lymphoma and under assessment in phase 3 clinical trials for
other B cell malignancies. To date, there are no reported cases
of hepatotoxicity secondary to zanubrutinib. We report the first
case of severe liver injury due to zanubrutinib. CASE
PRESENTATION: A 56-year-old Caucasian male with a history of
relapsed lymphoplasmacytic lymphoma was admitted to the hospital
with new-onset jaundice, choluria, and pruritus for 10 days. He
had been on zanubrutinib as part of a clinical trial for 30
months. His blood profile showed a severe hepatocellular injury
with jaundice (alanine transaminase 2474 IU/L and total
bilirubin 141 umol/L with mild coagulopathy). He had an
extensive work-up including virology, autoimmune, and metabolic
profiles in addition to abdominal ultrasound with no alternative
explanation found for his liver injury. Zanubrutinib-induced
liver injury was suspected, and causality assessment by the
updated Roussel Uclaf Causality Assessment Method score showed a
probable causal relationship with zanubrutinib. His liver
histology was also consistent with drug-induced liver injury.
His liver biochemistry improved following cessation of
zanubrutinib and normalised after 8 weeks. CONCLUSION: We report
the first case of severe liver injury secondary to zanubrutinib
after 30 months of treatment. This case raises clinical
awareness regarding zanubrutinib-induced liver toxicity and the
importance of drug withdrawal in the event of liver injury.
that has been recently licensed in refractory mantle cell
lymphoma and under assessment in phase 3 clinical trials for
other B cell malignancies. To date, there are no reported cases
of hepatotoxicity secondary to zanubrutinib. We report the first
case of severe liver injury due to zanubrutinib. CASE
PRESENTATION: A 56-year-old Caucasian male with a history of
relapsed lymphoplasmacytic lymphoma was admitted to the hospital
with new-onset jaundice, choluria, and pruritus for 10 days. He
had been on zanubrutinib as part of a clinical trial for 30
months. His blood profile showed a severe hepatocellular injury
with jaundice (alanine transaminase 2474 IU/L and total
bilirubin 141 umol/L with mild coagulopathy). He had an
extensive work-up including virology, autoimmune, and metabolic
profiles in addition to abdominal ultrasound with no alternative
explanation found for his liver injury. Zanubrutinib-induced
liver injury was suspected, and causality assessment by the
updated Roussel Uclaf Causality Assessment Method score showed a
probable causal relationship with zanubrutinib. His liver
histology was also consistent with drug-induced liver injury.
His liver biochemistry improved following cessation of
zanubrutinib and normalised after 8 weeks. CONCLUSION: We report
the first case of severe liver injury secondary to zanubrutinib
after 30 months of treatment. This case raises clinical
awareness regarding zanubrutinib-induced liver toxicity and the
importance of drug withdrawal in the event of liver injury.
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