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Severe Refractory Checkpoint Inhibitor‐Related Hepatitis Reversed With Anti‐Thymocyte Globulin and n‐Acetylcysteine

Immune checkpoint inhibitors (ICPIs) have revolutionized management of advanced melanoma. Combination ICPI treatment leads to immune-mediated effects including hepatitis with 15% being grade 3 or greater.[1] Management of severe ICPI immune-mediated hepatitis is immunotherapy discontinuation, steroids and mycophenolate mofetil (MMF).[1] Case reports have described outcomes of refractory immune-mediated hepatitis with the T-cell depleting agent anti-thymocyte globulin (ATG).