Table 5.

Cirrhosis-related disorders that should be considered in the diagnostic workup of irAEs in patients with HCC (Adapted from Sangro et al, J Hepatol 2020)178

Organ	irAE	Chronic liver disease
Skin	Pruritus Rash Erythema multiforme, psoriasis, urticaria and rosácea Severe cutaneous adverse reactions	Pruritus Skin disorders, including lichen planus, polyarteritis nodosa, cryoglobulinemic vasculitis, and porphyria cutanea tarda (HCV- and HBV-related)
GI tract	Diarrhea Colitis	Small intestine bacterial overgrowth Chronic pancreatitis
Liver	Hepatitis	Flares or viral infection
Lung	Pneumonitis	Hepatopulmonary syndrome Porto-pulmonary hypertension
Thyroid	Hypothyroidism Hyperthyroidism Graves’ disease	Reduced peripheral conversion of T4 to T3 Thyroid dysfunction
Adrenal glands and pituitary glands	Adrenal insufficiency Hypophysitis	Hypogonadism Hypothalamic-pituitary dysfunction Relative adrenal insufficiency
Kidney	Nephritis	Hepatorenal syndrome Mixed cryoglobulinemia (HCV-related) HBV-related nephropathy IgA nephropathy
Nervous system	Encephalitis Aseptic meningitis Peripheral neuropathy Myasthenia gravis Guillain-Barre syndrome Autonomic neuropathy Transverse myelitis	Porto-systemic encephalopathy (typical and atypical) Viral-related peripheral neuropathy Wernicke’s encephalopathy Autonomic neuropathy (HCV-related)
Blood and bone marrow	Cytopenias Hemolytic anemia Red cell aplasia Bone marrow failure Hemophilia A Hemophagocytic lymphohistiocytosis Macrophage activation syndrome	Hypersplenism and bone marrow depression Anemia due to folate or iron deficiency Hemolytic anemia Viral-related thrombotic thrombocytopenic purpura and aplastic anemia Immune thrombocytopenia (HCV-related) Lymphopenia related to HCC therapies

GI, gastrointestinal; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; irAE, immune-related adverse event.