Immune checkpoint inhibitors are antibodies that reactivate cytotoxic T cells by blocking immunosuppressive molecules such as cytotoxic T-lymphocyte-associated antigen 4 (e.g. ipilimumab) and programmed cell death protein (e.g. nivolumab). They are increasingly used in the treatment of various cancers including melanoma, renal cell carcinoma, non-small-cell lung cancer, hepatocellular carcinoma, etc. [1]. Unbalancing the immune system leads to immune-related adverse events involving all of the tissues, including the liver. Herein we present a melanoma patient who developed moderate HBV-related acute hepatitis due to exaggerated immune response after ipilimumab and nivolumab use.
23 September 2014 in Turkish Journal of Gastroenterology
Background/Aims: To investigate the relationship between gamma-glutamyl transpeptidase (GGT) levels and histopathological status determined by biopsy in patients with chronic hepatitis B and C. Materials and Methods: Patients with chronic hepatitis B and C who were referred to the Uludağ University Faculty of Medicine Gastroenterology outpatient clinic between January 2005-January 2011 and underwent liver biopsy were included in the study. Overall, 246 patients with hepatitis B and 151 patients with hepatitis C were enrolled. According to the evaluation based on the Ishak score, patients with a histological activity index (HAI) between 0-12 were defined as low activity, and those with an HAI between 13-18 were defined as high activity. In addition, patients with a fibrosis score of 0-2 were defined as low fibrosis, and those with a score between 3-6 were defined as high fibrosis; comparisons were made accordingly. Results: In patients with hepatitis B, the mean GGT level was 38.86±42.4 (IU/L) in the low activity group and 60.44±44.4 (IU/L) in the high activity group (p<0.05). In hepatitis B patients, the mean GGT level was 26.89±14.83 (IU/L) in the low fibrosis group, whereas it was 65.60±59.7 (IU/L) in the high fibrosis group (p<0.001). There was no significant difference between HAI and fibrosis group with regard to GGT levels in the hepatitis C patients. Conclusion: In conclusion, it is proposed that in patients with chronic viral hepatitis, GGT levels can be taken into consideration to predict advanced histological liver damage, especially in patients with hepatitis B.
Acute pancreatitis (AP) is a clinical condition that arises acutely in the pancreas through various inflammatory pathways due to multiple causes. Turkish Society of Gastroenterology Pancreas Working Group developed comprehensive guidance statements regarding the management of AP that include its epidemiology, etiology, clinical presentation, diagnostic criteria, disease severity, treatment, prognosis, local and systemic complications. The statements were developed through literature review, deliberation, and consensus opinion. These statements were ultimately used to develop a conceptual framework for the multidisciplinary management of AP. Cite this article as: Öğütmen Koç D, Bengi G, Gül Ö, et al. Turkish society of gastroenterology: Pancreas working group, acute pancreatitis committee consensus report. Turk J Gastroenterol. 2024;35(S1):S1-S44.