Hepatitis – Grade 1

Management escalation pathway

  • Continue ICPI
  • If bilirubin is increasing or in case of doubt: postpone 1 week:
    • if hereafter it remains stable or lowers: ICPI can be restarted
    • if hereafter it becomes grade II either for AST, ALT or bilirubin: perform serology and imagery to exclude other causes


ICPi: Immune Checkpoint Blockade Inhibition
ALT: Alanine Transaminase
AST: Aspartate Transaminase
ANA: Anti Nuclear Antibodies
ULN: Upper Limit of Normal
LFT: Liver Function Test
SMA: Smooth Muscle Antibody
LKM: Liver/Kidney Microsome type 1
SLA: Soluble Liver Antigen
LP: Liver/Pancreas
US: Ultra Sound