Immunotherapy · 2019
Late onset of nivolumab-induced severe gastroduodenitis and cholangitis in a patient with stage IV melanoma.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Cǎlugǎreanu Andreea, Rompteaux Pierre, Bohelay Gérôme, Goldfarb Lucas, Barrau Vincent, Cucherousset Nahla, Heidelberger Valentine, Nault Jean-Charles, Ziol Marianne, Caux Frédéric, Maubec Eve
Аннотация
Antiprogramed cell death-1 protein agents represent a therapeutic approach based on stimulating the host's immune response through blockade of immune checkpoints, inhibitory pathways that dampen the physiological peripheral T-cell immune response and are essential for maintaining self-tolerance. We describe the late onset of severe gastroduodenitis and cholangitis in a nivolumab-treated, metastatic melanoma patient in complete remission. Positron-emission tomography with computed tomography scans showed diffuse fluorodeoxyglucose (FDG) uptake in the stomach preceding upper digestive tract symptoms. Hence, positron-emission tomography with computed tomography might as well be a useful tool for early diagnosis of subclinical gastric toxicity as recently shown for colitis. Furthermore, physicians must be aware and remain vigilant to antiprogramed cell death-1 protein-related digestive toxicity that may appear very late during treatment.