开放胶囊型布地奈德治疗孤立性免疫检查点抑制剂诱导的肠炎。

Hussain Nadeen, Robert Marie, Al-Bawardy Badr

Department of Internal Medicine, Yale School of Medicine, New Haven, CT.

Department of Pathology, Yale School of Medicine, New Haven, CT.

ACG Case Rep J. 2022 Oct 7;9(10):e00882. doi: 10.14309/crj.0000000000000882. eCollection 2022 Oct.

Immune checkpoint inhibitors (ICIs) have revolutionized the management of various advanced-stage malignancies. The utilization of ICIs can be limited by their immune-related adverse events such as diarrhea and enterocolitis. Isolated ICI-induced enteritis is an uncommon presentation compared with ICI-induced colitis/enterocolitis. ICI withdrawal and systemic corticosteroids can lead to resolution of enterocolitis in up to 70% of patients. We present a rare case of isolated ICI-induced enteritis refractory to high-dose systemic corticosteroids and responsive to a course of open-capsule budesonide only.

免疫检查点抑制剂（ICI）彻底改变了各种晚期恶性肿瘤的治疗方式。ICI的应用可能会受到腹泻和小肠结肠炎等免疫相关不良事件的限制。与ICI诱导的结肠炎/小肠结肠炎相比，孤立性ICI诱导的小肠炎并不常见。停用ICI和全身性皮质类固醇可使高达70%的患者的小肠结肠炎得到缓解。我们报告了一例罕见的孤立性ICI诱导的小肠炎病例，该病例对高剂量全身性皮质类固醇难治，仅对一个疗程的开放胶囊布地奈德有反应。