A Case of Immune Checkpoint Inhibitor-Induced Duodenitis
Sandra Au1, Wei Chen2, Iris Vance3
1Department of Medicine, Duke University Health System, Durham, NC.
ACG Case Reports Journal
|October 18, 2024
Summary
Immune checkpoint inhibitors can cause gastrointestinal issues. This case shows pembrolizumab-induced duodenitis mimicking celiac disease, highlighting the need for further research.
Area of Science:
- Oncology
- Immunology
- Gastroenterology
Background:
- Immune checkpoint inhibitors (ICIs) like pembrolizumab enhance anti-cancer immunity but can cause immune-related adverse events (irAEs).
- Gastrointestinal irAEs are common but present diversely, posing diagnostic challenges.
Observation:
- A patient treated with pembrolizumab developed duodenitis with symptoms mimicking celiac disease.
- Despite initial interventions including a gluten-free diet, symptoms improved even after gluten reintroduction.
Findings:
- Endoscopic abnormalities persisted without complete resolution or progression post-pembrolizumab therapy.
- The duodenitis presentation resembled celiac disease but did not require a permanent gluten-free diet.
Implications:
- This case highlights the complex pathogenesis of ICI-induced duodenitis.
- Further investigation is needed to understand and manage these immune-related gastrointestinal conditions in patients receiving immunotherapy.
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