Immune checkpoint inhibitor refractory colitis leading to total colectomy in a melanoma patient.

IF 1.3 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY
N Baczewska, M Philippart, J Siplet, J-F Baurain, L Stainier, E Laterre, L Duck, J-C Coche
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引用次数: 0

Abstract

Immunotherapy is becoming more and more relevant in the treatment of advanced melanoma. Proper management of its side effects can prevent severe complications. We describe the case of a 73-year-old patient with severe refractory colitis secondary to immunotherapy. The patient has been treated for 6 months with Nivolumab, an anti-PD-1, as adjuvant therapy for locally advanced melanoma. He was admitted to the hospital with a deteriorating general condition associated with severe diarrhea and rectal bleeding for 3 weeks. Despite three lines of treatment (high dose corticosteroids, infliximab, mycophenolate mofetil), the patient still presented clinical and endoscopic colitis, with additional infectious complications. The patient required surgical management for total colectomy. In this article we present one of the rare cases of autoimmune colitis that did not respond to various immunosuppressive treatments and required surgery.

免疫检查点抑制剂难治性结肠炎导致黑色素瘤患者全结肠切除术。
免疫疗法在晚期黑色素瘤的治疗中越来越重要。正确处理其副作用可以预防严重的并发症。我们描述的情况下,73岁的病人严重难治性结肠炎继发免疫治疗。该患者已经接受了6个月的Nivolumab(一种抗pd -1)治疗,作为局部晚期黑色素瘤的辅助治疗。他入院时一般情况恶化,伴有严重腹泻和直肠出血3周。尽管接受了三线治疗(高剂量皮质类固醇、英夫利昔单抗、霉酚酸酯),患者仍然出现了临床和内镜下结肠炎,并伴有其他感染并发症。患者需要手术进行全结肠切除术。在这篇文章中,我们提出了一例罕见的自身免疫性结肠炎,对各种免疫抑制治疗没有反应,需要手术治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta gastro-enterologica Belgica
Acta gastro-enterologica Belgica Medicine-Gastroenterology
CiteScore
2.30
自引率
20.00%
发文量
78
期刊介绍: The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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