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. 2023 Feb 13;7(2):87–97. doi: 10.1002/jgh3.12868

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© 2023 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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Clinical course after first course of ipilimumab + nivolumab combination therapy in case 1. The day of ir‐hepatitis onset was defined as day 0. The patient was diagnosed with immune‐related dermatologic disorder on day 11, and 60 mg/day of mPSL was administered intravenously. On day 0, fever persisted, and abnormal blood test results were observed: AST, ALT, and ALP levels were 427, 202, and 1518 IU/L. On days 1–3, a steroid pulse treatment (mPSL, 1000 mg/day) was given; furthermore, MMF administration was commenced on day 2. On day 2, fever subsided, and on day 3, the dose was changed from 1000 mg/day mPSL to 160 mg/day PSL. After day 9, ir‐hepatitis rapidly improved, and PSL was gradually reduced. MMF was administered at a reduced dose of 1000 mg/day on day 25 and then discontinued on day 31. Since then, PSL dose was gradually reduced and there was no recurrence of ir‐hepatitis.