Morino Koshiro, Nagatomo Shu, Ishida Kunpei, Ueo Taro, Machimoto Takafumi
Department of Gastroenterological Surgery, Tenri Hospital, Tenri, JPN.
Department of Gastroenterology, Tenri Hospital, Tenri, JPN.
Cureus. 2024 Sep 2;16(9):e68480. doi: 10.7759/cureus.68480. eCollection 2024 Sep.
Immune checkpoint inhibitors (ICIs) have been approved for treating various advanced malignancies. Immune-related adverse events (irAEs) can manifest diversely and at varying times. However, postoperative diarrhea is a common complication in pancreaticoduodenectomy (PD). This case report presents a unique instance of delayed-onset irAE colitis occurring one year after PD in a patient with gastric cancer who received neoadjuvant nivolumab, a monoclonal antibody targeting human programmed death 1. A 54-year-old male developed severe diarrhea and weight loss, ultimately diagnosed with irAE colitis, which responded to steroid therapy. This report underscores the importance of extended monitoring, recognizing the potential for late-onset toxicities associated with ICIs, and differentiating from PD-related diarrhea.
免疫检查点抑制剂（ICIs）已被批准用于治疗各种晚期恶性肿瘤。免疫相关不良事件（irAEs）可在不同时间表现出不同症状。然而，术后腹泻是胰十二指肠切除术（PD）的常见并发症。本病例报告呈现了1例独特的延迟性irAE结肠炎病例，该病例发生在1例接受新辅助纳武利尤单抗（一种靶向人程序性死亡蛋白1的单克隆抗体）治疗的胃癌患者PD术后1年。一名54岁男性出现严重腹泻和体重减轻，最终被诊断为irAE结肠炎，对类固醇治疗有反应。本报告强调了延长监测的重要性，认识到与ICIs相关的迟发性毒性的可能性，并与PD相关腹泻相鉴别。
