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孤立性免疫检查点抑制剂诱发的胃炎导致胃结肠瘘形成。

Isolated Immune Checkpoint Inhibitor-Induced Gastritis Leading to Gastrocolic Fistula Formation.

作者信息

Shrivastava Samarth, Patel Neha

机构信息

Department of Pediatrics, Division of Combined Internal Medicine and Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.

Department of Internal Medicine, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX.

出版信息

ACG Case Rep J. 2024 Jul 12;11(7):e01431. doi: 10.14309/crj.0000000000001431. eCollection 2024 Jul.

Abstract

Immune checkpoint inhibitors (ICIs) are important immunotherapeutic tools with known potential for adverse events (immune-related adverse events [irAEs]) in the gastrointestinal system. Although ICI-induced colitis and diarrhea are well documented, irAEs localized to the stomach are less frequently described. The management of most irAEs is suspension of ICI therapy and immune suppression. In rare cases of ICI-induced gastritis, treatment strategies of immune suppression have been scarcely described. To our knowledge, there have been no reported cases of severe ICI-induced gastritis leading to fistula formation. This case report describes a patient with isolated ICI-induced gastritis leading to an ulcer with gastrocolic fistula and his treatment course.

摘要

免疫检查点抑制剂(ICIs)是重要的免疫治疗工具,已知其在胃肠道系统有引发不良事件(免疫相关不良事件[irAEs])的可能性。尽管ICI诱发的结肠炎和腹泻已有充分记录,但局限于胃部的irAEs较少被描述。大多数irAEs的管理方法是暂停ICI治疗并进行免疫抑制。在罕见的ICI诱发胃炎病例中,免疫抑制的治疗策略鲜有描述。据我们所知,尚无严重的ICI诱发胃炎导致瘘管形成的病例报告。本病例报告描述了一名因孤立性ICI诱发胃炎导致溃疡并伴有胃结肠瘘的患者及其治疗过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b3d/11245220/d9b61915ef36/ac9-11-e01431-g001.jpg

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