Fulminant immune-related colitis after dual checkpoint inhibitor therapy: case report.

IF 2.7 4区 医学 Q3 IMMUNOLOGY Immunotherapy Pub Date : 2024-01-01 Epub Date: 2024-08-19 DOI:10.1080/1750743X.2024.2386234
Robert Lukin, Aaron Ciner
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Abstract

Aim: Immune-related (IR) colitis is a potentially life-threatening complication of checkpoint inhibitors. Its presentation often includes diarrhea, abdominal pain and rectal bleeding and the median time to onset is 6-10 weeks post initiation of immunotherapy.Case study: We report an unusual case of fulminant IR-colitis beginning 3 days after the first dose of dual checkpoint blockade. IR-colitis was refractory to high-dose corticosteroids and was further complicated by sigmoid diverticulum perforation.Conclusion: Early-onset IR-colitis can occur, particularly in the context of combined anti-PD1 and anti-CTLA4 blockade, and clinicians should maintain a high-index of suspicion even when timing of symptom onset is atypical. Further research is needed to elucidate risk factors for early-onset IR-colitis.

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双检查点抑制剂治疗后的恶性免疫相关性结肠炎:病例报告。
目的:免疫相关(IR)结肠炎是一种可能威胁生命的检查点抑制剂并发症。其表现通常包括腹泻、腹痛和直肠出血,中位发病时间为免疫疗法开始后的 6-10 周。病例研究:我们报告了一个不寻常的病例,患者在首次服用双重检查点阻断剂3天后开始出现暴发性IR-结肠炎。IR-结肠炎对大剂量皮质类固醇难治,并因乙状结肠憩室穿孔而进一步复杂化。结论即使症状出现的时间不典型,临床医生也应保持高度怀疑。需要进一步研究阐明早发IR-结肠炎的风险因素。
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来源期刊
Immunotherapy
Immunotherapy 医学-免疫学
CiteScore
5.00
自引率
3.60%
发文量
113
审稿时长
6-12 weeks
期刊介绍: Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field. Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.
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