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Immune Checkpoint Inhibitor-Associated Hepatobiliary Toxicity: A Case of Concurrent Immune-Mediated Hepatitis and Acalculous Cholecystitis.

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ACG case reports journal 📖 저널 OA 100% 2023: 1/1 OA 2024: 3/3 OA 2025: 20/20 OA 2026: 23/23 OA 2023~2026 2026 Vol.13(4) p. e02097 OA Cancer Immunotherapy and Biomarkers
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PubMed DOI PMC OpenAlex 마지막 보강 2026-04-30
OpenAlex 토픽 · Cancer Immunotherapy and Biomarkers Cholangiocarcinoma and Gallbladder Cancer Studies Liver Diseases and Immunity

Ravella B, Gadde EC, Lokineni S

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Immune checkpoint inhibitors are associated with immune-related adverse events, including immune-mediated hepatitis, while acute acalculous cholecystitis remains exceedingly rare.

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APA Balakrishna Ravella, Eswar Gadde, Sravani Lokineni (2026). Immune Checkpoint Inhibitor-Associated Hepatobiliary Toxicity: A Case of Concurrent Immune-Mediated Hepatitis and Acalculous Cholecystitis.. ACG case reports journal, 13(4), e02097. https://doi.org/10.14309/crj.0000000000002097
MLA Balakrishna Ravella, et al.. "Immune Checkpoint Inhibitor-Associated Hepatobiliary Toxicity: A Case of Concurrent Immune-Mediated Hepatitis and Acalculous Cholecystitis.." ACG case reports journal, vol. 13, no. 4, 2026, pp. e02097.
PMID 42005009 ↗

Abstract

Immune checkpoint inhibitors are associated with immune-related adverse events, including immune-mediated hepatitis, while acute acalculous cholecystitis remains exceedingly rare. We report a 52-year-old man with metastatic melanoma who developed concurrent grade 3 immune-mediated hepatitis and acute acalculous cholecystitis 2 weeks after combination ipilimumab-nivolumab therapy. He presented with right upper quadrant pain, jaundice, and marked transaminitis. Imaging showed gallbladder wall thickening with pericholecystic fluid without cholelithiasis, and alternative etiologies were excluded. The patient improved with conservative management without corticosteroids, with complete symptom resolution and biochemical normalization. This case highlights a rare dual hepatobiliary immune-related toxicity and the potential for conservative management in selected patients.

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