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Concurrent Immune-related Enteritis and Cytomegalovirus Enteritis during Immune Checkpoint Inhibitor Therapy
Yuka Yamada1, Norio Kodaka1, Saeko Shinozawa1
1Division of Respiratory Medicine, Department of Internal Medicine, Toho University Ohashi Medical Center, Japan.
Abstract:
Immune checkpoint inhibitors (ICIs) are widely used for advanced lung cancer; however, isolated ileitis and subsequent perforation are rare, particularly when complicated by cytomegalovirus (CMV) infection.A woman in her 50s with stage IV lung adenocarcinoma developed ICI-associated enteritis after atezolizumab-based therapy, which partially improved with corticosteroids and infliximab, but she later experienced ileal perforation following second-line chemotherapy. A histopathological examination revealed ICI-induced enteritis with cytomegalovirus (CMV) inclusions. Despite antiviral therapy with ganciclovir, the patient died. We present the first report of pathologically confirmed ICI-induced ileitis complicated by CMV enteritis in resected small bowel tissue.
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