A Case of Immunotherapy-Induced Colitis Complicated by Perforation and Treated with Infliximab Postoperatively
The advent of checkpoint inhibitor therapy in medical oncology has led to an increase in hospitalizations for immune-related adverse effects. Severe colitis has been reported in approximately 5% of patients treated with cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) inhibitors, such as ipilimu...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Oncological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/9069354 |
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| author | Lukas Delasos Aakash Desai Nerea Lopetegui Lia Nikhila Kethireddy Carolyn Ray |
| author_facet | Lukas Delasos Aakash Desai Nerea Lopetegui Lia Nikhila Kethireddy Carolyn Ray |
| author_sort | Lukas Delasos |
| collection | DOAJ |
| description | The advent of checkpoint inhibitor therapy in medical oncology has led to an increase in hospitalizations for immune-related adverse effects. Severe colitis has been reported in approximately 5% of patients treated with cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) inhibitors, such as ipilimumab. Standard management for those with severe colitis includes administration of systemic corticosteroids with the reservation of antitumor necrosis factor (anti-TNF) therapy, such as infliximab, if there has been no improvement. Rarely, immunotherapy-induced colitis can become life-threatening and result in bowel perforation requiring surgical intervention. Yet, there are no specific recommendations for medical management following colectomy in these situations. In cases of severe colitis from Crohn’s disease, postoperative treatment with infliximab has been found to be safe when administered shortly after intestinal resection. However, there remains limited data to support administration of infliximab following bowel perforation due to immunotherapy-induced colitis. Our case illustrates management of a severe adverse reaction to checkpoint inhibitor therapy and the need to further evaluate the role of infliximab postoperatively in patients who develop colitis complicated by bowel perforation. |
| format | Article |
| id | doaj-art-aae8150bccc04afaadac6fcbc0bc0d80 |
| institution | Kabale University |
| issn | 2090-6706 2090-6714 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Oncological Medicine |
| spelling | doaj-art-aae8150bccc04afaadac6fcbc0bc0d802025-02-03T01:12:24ZengWileyCase Reports in Oncological Medicine2090-67062090-67142019-01-01201910.1155/2019/90693549069354A Case of Immunotherapy-Induced Colitis Complicated by Perforation and Treated with Infliximab PostoperativelyLukas Delasos0Aakash Desai1Nerea Lopetegui Lia2Nikhila Kethireddy3Carolyn Ray4Department of Medicine, University of Connecticut, Farmington, CT, USADepartment of Medicine, University of Connecticut, Farmington, CT, USADepartment of Medicine, University of Connecticut, Farmington, CT, USADepartment of Medicine, University of Connecticut, Farmington, CT, USADepartment of Medical Oncology, Smilow Cancer Hospital at St. Francis, Hartford, CT, USAThe advent of checkpoint inhibitor therapy in medical oncology has led to an increase in hospitalizations for immune-related adverse effects. Severe colitis has been reported in approximately 5% of patients treated with cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) inhibitors, such as ipilimumab. Standard management for those with severe colitis includes administration of systemic corticosteroids with the reservation of antitumor necrosis factor (anti-TNF) therapy, such as infliximab, if there has been no improvement. Rarely, immunotherapy-induced colitis can become life-threatening and result in bowel perforation requiring surgical intervention. Yet, there are no specific recommendations for medical management following colectomy in these situations. In cases of severe colitis from Crohn’s disease, postoperative treatment with infliximab has been found to be safe when administered shortly after intestinal resection. However, there remains limited data to support administration of infliximab following bowel perforation due to immunotherapy-induced colitis. Our case illustrates management of a severe adverse reaction to checkpoint inhibitor therapy and the need to further evaluate the role of infliximab postoperatively in patients who develop colitis complicated by bowel perforation.http://dx.doi.org/10.1155/2019/9069354 |
| spellingShingle | Lukas Delasos Aakash Desai Nerea Lopetegui Lia Nikhila Kethireddy Carolyn Ray A Case of Immunotherapy-Induced Colitis Complicated by Perforation and Treated with Infliximab Postoperatively Case Reports in Oncological Medicine |
| title | A Case of Immunotherapy-Induced Colitis Complicated by Perforation and Treated with Infliximab Postoperatively |
| title_full | A Case of Immunotherapy-Induced Colitis Complicated by Perforation and Treated with Infliximab Postoperatively |
| title_fullStr | A Case of Immunotherapy-Induced Colitis Complicated by Perforation and Treated with Infliximab Postoperatively |
| title_full_unstemmed | A Case of Immunotherapy-Induced Colitis Complicated by Perforation and Treated with Infliximab Postoperatively |
| title_short | A Case of Immunotherapy-Induced Colitis Complicated by Perforation and Treated with Infliximab Postoperatively |
| title_sort | case of immunotherapy induced colitis complicated by perforation and treated with infliximab postoperatively |
| url | http://dx.doi.org/10.1155/2019/9069354 |
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