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Severe Lenalidomide-Associated Hyperbilirubinemia.

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Citation: Cureus. 15(1):e34408, 2023 Jan.PMID: 36874759Department: Internal Medicine Residency | MedStar Georgetown University Hospital/MedStar Washington Hospital CenterForm of publication: Journal ArticleMedline article type(s): Case ReportsYear: 2023 ISSN:

2168-8184

Name of journal: CureusAbstract: Immunomodulatory drugs (IMids), such as thalidomide and lenalidomide, are used to treat plasma cell neoplasms and B-cell malignancies. We present a case of severe direct hyperbilirubinemia in a patient taking lenalidomide-based therapy for plasmacytoma. Imaging was unrevealing, and liver biopsy showed only mild sinusoidal dilation. Roussel Uclaf Causality Assessment (RUCAM) score was 6, indicating lenalidomide was a probable cause of the injury. To our knowledge, this is the highest reported direct bilirubin regarding lenalidomide drug-induced liver injury (DILI), with a peak bilirubin of 41mg/dL. While a clear pathophysiology was not identified, this case provides important considerations regarding lenalidomide safety. Copyright © 2023, Gildea et al.All authors: Gildea DT, Roswarski JLFiscal year: FY2023 Digital Object Identifier:

https://dx.doi.org/10.7759/cureus.34408

Date added to catalog: 2023-04-11

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Journal Article	MedStar Authors Catalog	Article		Available

Immunomodulatory drugs (IMids), such as thalidomide and lenalidomide, are used to treat plasma cell neoplasms and B-cell malignancies. We present a case of severe direct hyperbilirubinemia in a patient taking lenalidomide-based therapy for plasmacytoma. Imaging was unrevealing, and liver biopsy showed only mild sinusoidal dilation. Roussel Uclaf Causality Assessment (RUCAM) score was 6, indicating lenalidomide was a probable cause of the injury. To our knowledge, this is the highest reported direct bilirubin regarding lenalidomide drug-induced liver injury (DILI), with a peak bilirubin of 41mg/dL. While a clear pathophysiology was not identified, this case provides important considerations regarding lenalidomide safety. Copyright © 2023, Gildea et al.

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