A case report of immune checkpoint inhibitor-related myositis and cholangitis induced by pembrolizumab.

C‐reactive protein and ALT levels showed a decreasing trend after the treatment initiation; however, relapse was observed when the PSL dose was reduced to 15 mg and MMF was switched to azathioprine (AZA) on day 147. 1.3 Outcome and follow‐up Despite treatment modification, the hepatobiliary enzyme levels did not improve, and MRCP showed progressive narrowing of irregular intraductal bile ducts and peripheral bile duct dilatation (Figure 2D ).

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Myositis showed a trend toward improvement, with the disappearance of the high signal in the T2 fat‐suppressed image on MRI of the right adductor magnus and right erector spinae muscles.

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