Concurrent Immune-Related Polyarthritis and Hyperbilirubinemia during Atezolizumab Plus Bevacizumab Therapy for Hepatocellular Carcinoma: A Steroid-Responsive Case

Key Points

• To report a case of immune-related polyarthritis and hyperbilirubinemia occurring during immune checkpoint therapy for hepatocellular carcinoma.
• Case study of a male patient in his 70s with hepatitis C-related cirrhosis undergoing treatment with atezolizumab and bevacizumab.
• Clinical evaluation included assessment of arthralgia and hyperbilirubinemia after the 12th and 13th treatment courses.
• Diagnosis of immune-related adverse events included exclusion of other liver disease causes and subsequent steroid administration.
• Patient experienced joint pain and improved rapidly with steroid treatment, diagnosed as immune-related polyarthritis.
• Elevated total bilirubin levels reached 10.09 mg/dL without evidence of bile duct obstruction or other liver diseases.
• Repeat steroid treatment led to symptom improvement, highlighting the importance of distinguishing immune-related adverse events during therapy.