Moein Hamid-Reza, Rutledge Brian, Beydoun Rafic, Ehrinpreis Murray N
Internal Medicine, Sinai-Grace Hospital/Detroit Medical Center, Wayne State University School of Medicine, Detroit, USA.
Gastroenterology, Wayne State University Detroit Medical Center, Detroit, USA.
Cureus. 2021 Apr 11;13(4):e14414. doi: 10.7759/cureus.14414.
Ipilimumab and nivolumab are immune checkpoint inhibitors that have recently been used in the treatment of metastatic melanoma and other cancers. Immune-mediated colitis is one of their adverse events that need to be differentiated from low-grade diarrhea as one of the most common side effects. A 51-year-old woman with relapsed metastatic melanoma presented with intractable diarrhea, nausea, vomiting, and generalized abdominal pain. The patient had been treated with ipilimumab and nivolumab in the past two months. The infectious workup was inconclusive. Colonoscopy demonstrated severe colitis, and biopsies were consistent with colitis. Combination chemotherapy was stopped. The patient was treated with intravenous and oral steroids, and her symptoms improved. A combination of ipilimumab and nivolumab increases the chance of immune-mediated colitis, and steroids should be started promptly to avoid complications such as bowel perforation and toxic megacolon.
伊匹单抗和纳武单抗是免疫检查点抑制剂，最近被用于治疗转移性黑色素瘤和其他癌症。免疫介导的结肠炎是它们的不良事件之一，需要与作为最常见副作用之一的轻度腹泻相鉴别。一名51岁复发转移性黑色素瘤女性患者出现顽固性腹泻、恶心、呕吐和全腹痛。该患者在过去两个月接受了伊匹单抗和纳武单抗治疗。感染性检查结果不明确。结肠镜检查显示严重结肠炎，活检结果与结肠炎相符。联合化疗停止。患者接受了静脉和口服类固醇治疗，症状有所改善。伊匹单抗和纳武单抗联合使用会增加免疫介导结肠炎的发生几率，应迅速开始使用类固醇以避免诸如肠穿孔和中毒性巨结肠等并发症。
