Immune-Related Toxicity: Not always the Culprit

Abstract

He was admitted into the emergency room on September 2020 due to a three-day grade 3 emesis and rapidly progressive weight loss. Complementary studies showed grade 3 immune-related gastritis, with great response to corticosteroids within 2 days of treatment. He received metilprednisolone 1mg/kg/day for one month, and then, we started corticosteroid tapering. However, we could not lower the dose from prednisone 30 mg/day because grade 2 emesis and grade 2 diarrhea appeared. We considered starting Infliximab 5 mg/kg for corticosteroid refractory immunerelated toxicity(irAEs) but we needed an endoscopic study first, as ESMO guidelines recommend [1]. Pre-antiTNF screening with viral serologies an IGRA was negative.