Abstract
Nivolumab is an immune checkpoint inhibitor (ICI), which is used for treatment of advanced malignancies. Diarrhea is a typical adverse effect of ICIs. Several endoscopic features of ICI-related colitis have been reported. Herein, we reported a case of ICI-related colitis, with successful follow-up using ultrasonography (US). A 54-year-old woman, diagnosed with renal cell carcinoma, underwent radical nephrectomy. Multiple liver and bone metastases appeared 6 months after surgery. She was prescribed sunitinib, which was discontinued, because of severe diarrhea. She was prescribed nivolumab after 1 week. However, she was hospitalized 9 days later, due to fever and diarrhea. US showed diffuse wall thickening from the cecum to the rectum. The wall layer structures were preserved, and thickening was observed mainly in the submucosa, but not in the mucosa, without a decrease in the echo level. Subsequently, sigmoidoscopy was performed. Severe edema was observed in the mucosa, without any erosion and granularity. She was clinically diagnosed with ICI-related colitis, and steroid therapy was administered. One week after steroid therapy, the diarrhea improved, and the earlier findings showed marked improvement on US. After another week of reduced steroid dose, US revealed further improvement, and she was discharged.
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Yoshito Komatsu received lecture fees from Eli Lilly Japan K.K., ONO PHARMACEUTICAL CO., Ltd., TAIHO Phamaceutical CO., Ltd., Chugai Phamaceutical CO., Ltd., Takeda Pharmaceutical CO., Ltd., Bayer Yakuhin, Ltd., Bristol-Myers Squibb Co., Sanofi-aventis S.A., Merck Biopharma Co., Ltd., Yakult Honsha Ltd., Pfizer Japan Inc. and received a research grant from Mediscience Planning Inc.
Nobuo Shinohara received lecture fees from Pfizer Japan Inc., ONO PHARMACEUTICAL CO., Ltd., Novartis Pharma K.K., Bayer Yakuhin, Ltd., Astellas Pharma Inc., Takeda Pharmaceutical CO., Ltd., GSK, AstraZeneca, Janssen Pharmaceutical K.K., and MSD and received a research grant from ONO Phamaceutical CO., Ltd. and Astellas Pharma Inc.
Takanori Teshima received personal fees from Merck Sharp & Dohme Corp, grants and personal fees from Kyowa Hakko Kirin Co., Ltd., personal fees from Takeda Pharmaceutical CO., Ltd., grants, personal fees and non-financial support from Novartis Pharma K.K., personal fees from Pfizer Japan Inc., personal fees from Bristol-Myers Squibb, grants from Chugai Pharmaceutical Co., Ltd., grants from Sanofi K K, grants from Astellas Pharma Inc., grants from TEIJIN PHARMA LIMITED., grants from Fuji Pharma Co., Ltd., grants from NIPPON SHINYAKU CO., Ltd., non-financial support from Janssen Pharmaceutical K.K.
Satomi Omotehara, Mutsumi Nishida, Kazunori Nagashima, Takehiko Katsurada, Tetsuhito Muranaka, Tomoko Mitsuhashi, Hitoshi Shibuya, Takashige Abe, Ryuji Matsumoto and Junichi Sugita declare that they have no conflict of interest.
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Omotehara, S., Nishida, M., Nagashima, K. et al. Immune Checkpoint Inhibitor-Induced Colitis Successfully Followed up by Ultrasonography. SN Compr. Clin. Med. 2, 215–221 (2020). https://doi.org/10.1007/s42399-019-00211-0
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DOI: https://doi.org/10.1007/s42399-019-00211-0