HEP-19-1549 Pembrolizumab as a cause of cholangiopathy in a patient with metastatic melanoma.

Programmed cell death protein 1 receptor (PD-1) is a cell surface protein involved in immune response regulation. Pembrolizumab is a monoclonal antibody against PD-1 and used to treat patients with stage IV and III melanoma.(1) Immune-related hepatotoxicity is reported in 2-10% of patients(2) with case reports of vanishing bile duct syndrome(3), subacute biliary injury and immune cholangitis.(4).