Nintedanib induced liver injury: A rare case report

Abstract

Nintedanib (BIBF 1120) is a potent intracellular inhibitor of tyrosine kinase receptors, including vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors α and β, and non-receptors members of the Src family [1]. By binding competitively to the adenosine triphosphate sites of these receptors, Nintedanib blocks autophosphorylation and so inhibits the downstream intracellular signalling cascades necessary for the proliferation, migration and survival of endothelial cells, pericytes, and fibroblasts [2]. Nintedanib is approved in the European Union in combination with docetaxel for the treatment of Non- Small Cell Lung Cancer (NSCLC) of adenocarcinoma histology after first-line chemotherapy and for the treatment of Idiopathic Pulmonary Fibrosis (IPF) [3-5].We report a patient, who was admitted at Gastroenterology department with complaints of itching, yellowish discolouration of eyes, concentrated urine for 1 month & cough with shortness of breath for 3 days.He was taking treatment for Type II Diabetes Mellitus and Hypertension for past 5 & 8 years respectively. The patient also had a medical history of Interstitial Lung Disease (ILD) and was taking Cap Nintedanib for 1 month.