부산대학교 도서관

Background. Alectinib has high efficacy for anaplastic lymphoma kinase (ALK)-positive lung cancer, and severe liver dysfunction due to alectinib is rare. Acute hepatitis due to hepatitis C virus (HCV) is also rare compared to that induced by hepatitis B virus. Case. A 51-year-old man presented to our hospital with an abnormal shadow on chest radiography. The patient was diagnosed with stage IIB (cT1bN1M0) lung adenocarcinoma via a transbronchial lung biopsy. He received left pneumonectomy performed via video-assisted thoracic surgery. A biomarker analysis revealed strong immunohistochemical staining for ALK protein. However, fluorescent in situ hybridization (FISH) did not show ALK translocation. He was prescribed alectinib for the relapse of lung adenocarcinoma. However, on day 5 after administration of alectinib, blood tests showed liver dysfunction, and alectinib administration was discontinued. Blood test results for hepatitis B surface (HBs) antigen, HBs antibody, and HCV antibody were not remarkable. After discontinuation, the liver function results worsened. He was administered steroid pulse therapy due to the possibility of an adverse drug event or autoimmune hepatitis. On day 27 after the administration of alectinib, blood samples tested positive for HCV antibody and HCV-RNA. He was diagnosed with acute hepatitis due to HCV infection. His liver function gradually improved. Conclusion. We should consider the possibility of acute hepatitis by HCV during the treatment of lung cancer.