免疫疗法越来越多地用于治疗各种类型的癌症；然而，它通常会导致免疫相关不良事件 (irAE)。免疫相关性硬化性胆管炎 (irSC) 是一种罕见的肝脏 irAE，仅在少数病例中被描述，并且其最佳治疗方法仍有很多未知之处。在本报告中，我们描述了一名 70 多岁男性的病例，他被诊断患有转移性黑色素瘤并接受了派姆单抗治疗。他经历了多种 irAE，包括 irSC，对初始泼尼松治疗（每日 2 毫克/公斤剂量）没有反应。然而，随后用熊去氧胆酸 (UDCA) 治疗导致症状完全缓解，并且与 irSC 相关的实验室和放射学异常正常化。我们的案例表明，传统上用于治疗 irAE 的类固醇可能对 irSC 无效，而 UDCA 可能是更好的替代方案。临床医生应注意这种罕见的 irAE。© BMJ Publishing Group Limited 2023。不得商业重复使用。请参阅权利和权限。由英国医学杂志出版。

Immunotherapy is increasingly used to treat various types of cancer; however, it can often result in immune-related adverse events (irAEs). Immune-related sclerosing cholangitis (irSC) is a rare type of hepatic irAE that has been described only in a few cases, and much remains unknown about its optimal treatment. In this report, we describe the case of a man in his 70s who was diagnosed with metastatic melanoma and treated with pembrolizumab. He experienced multiple irAEs, including irSC, which did not respond to initial prednisone treatment (2 mg/kg daily dosing). However, subsequent treatment with ursodeoxycholic acid (UDCA) resulted in complete resolution of symptoms and normalisation of laboratory and radiographic abnormalities related to irSC. Our case suggests that steroids, which are traditionally used to treat irAEs, may be ineffective for irSC and that UDCA may be a better alternative. Clinicians should be aware of this rare irAE.© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.