Jasdeep Bathla^1,, George Kidess², Kenan Abouchaer¹, Ayman Salem¹, Dana Kabbani¹

Immune checkpoint inhibitors, or ICI’s, are an advanced immunotherapy that is increasingly used in a range of malignant disorders. Given such widespread use, attention to the side effect profile of these agents is needed given an array of complications, specifically, drug-induced liver injury (DILI). Although rarely encountered, DILI can be life-threatening given the precarious prognosis of this patient population. We present a case of DILI due to a specific subset of ICI’s known as programmed cell death protein 1 (PD-1) inhibitors which unfortunately resulted in a fatal outcome. The patient had history of relapsed Hodgkin's lymphoma on salvage immunotherapy with pembrolizumab and despite appropriate management, ultimately succumbed to multiorgan failure. Despite potential for such disastrous outcomes, this class of medications remains relatively safer than alternative therapies. This case highlights a specific deleterious effect of this drug class while advocating for further investigation into the link between ICI use and DILI.

pembrolizumab, immune checkpoint inhibitor, immunotherapy, drug induced liver injury