An ICI is a monoclonal antibody that targets one of the immune checkpoint molecules.
Clinical features of hepatotoxicity:
(1) onset or worsening of liver disease after starting the ICI therapy
(2) fatigue, malaise, myalgias, abdominal discomfort, jaundice and other signs and symptoms
(3) exclusion of other causes
(4) clinical improvement after discontinuing the ICI therapy
(5) variable responses to corticosteroid and immunosuppressive therapy
Liver disease may involve:
(1) autoimmune hepatitis, with elevations of serum AST and ALT
(2) biliary ducts (including vanishing bile duct syndrome), with elevations of total serum bilirubin and serum alkaline phosphatase
(3) mixed
