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Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Liver Injury Associated with Ocrelizumab Use: A Case Report

Version 1 : Received: 20 April 2023 / Approved: 21 April 2023 / Online: 21 April 2023 (09:41:29 CEST)

How to cite: Harata, M.; Rustam, L.; Gunderson, A. Liver Injury Associated with Ocrelizumab Use: A Case Report. Preprints 2023, 2023040705. https://doi.org/10.20944/preprints202304.0705.v1 Harata, M.; Rustam, L.; Gunderson, A. Liver Injury Associated with Ocrelizumab Use: A Case Report. Preprints 2023, 2023040705. https://doi.org/10.20944/preprints202304.0705.v1

Abstract

Drug induced liver injury (DILI) is the most common cause of acute liver failure and 5-10% of patients hospitalized for jaundice are diagnosed with DILI. For a diagnosis of DILI to be made, there should be exclusion of other etiologies of liver injury and the use of a precipitator drug, latency of symptoms, and resolution of liver injury once the offending drug is identified and discontinued. In our case report, we present a patient with idiosyncratic hepatocellular pattern DILI after two doses of ocrelizumab for treatment of multiple sclerosis. Ocrelizumab was given 16 and 27 days prior to the onset of icterus, jaundice, and fatigue, in a patient without the evidence of prior exposure to hepatitis B virus. At presentation labs revealed severe acute hepatocellular liver injury with R factor of 30.42, marked hyperbilirubinemia, and transient hypoalbuminemia. No evidence of latent or active hepatitis B infection was detected. Drug dechallenge led to return of liver chemistries to near-normal levels 31 days after the onset of her symptoms. This case indicates DILI diagnosis associated with the use of ocrelizumab, and warrants careful monitoring of liver functions in patients even in the absence of hepatitis B.

Keywords

Drug-induced liver injury; ocrelizumab; hepatotoxicity

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

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