A Celiac Disease Phenotype After Checkpoint Inhibitor Exposure: An Example of Immune Dysregulation After Immunotherapy

Celiac disease is characterized by duodenal inflammation after exposure to gluten. Checkpoint inhibitors are antibodies that inhibit the inhibitory signals of the cytotoxic T lymphocytes to enhance antitumor responses. A 79-year-old man with an unknown history of celiac disease underwent treatment w...

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Detalles Bibliográficos
Autores principales: Arnouk, Joud, Mathew, Don, Nulton, Ethan, Rachakonda, Vikrant
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2019
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791616/
https://www.ncbi.nlm.nih.gov/pubmed/31737699
http://dx.doi.org/10.14309/crj.0000000000000158
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author Arnouk, Joud
Mathew, Don
Nulton, Ethan
Rachakonda, Vikrant
author_facet Arnouk, Joud
Mathew, Don
Nulton, Ethan
Rachakonda, Vikrant
author_sort Arnouk, Joud
collection PubMed
description Celiac disease is characterized by duodenal inflammation after exposure to gluten. Checkpoint inhibitors are antibodies that inhibit the inhibitory signals of the cytotoxic T lymphocytes to enhance antitumor responses. A 79-year-old man with an unknown history of celiac disease underwent treatment with pembrolizumab for recurrent left maxillary melanoma. He subsequently developed diarrhea and weight loss. Serology was positive for anti-tissue transglutaminase immunoglobulin A. Upper endoscopy revealed duodenal villous atrophy, which was confirmed on biopsy. A gluten-free diet was not tolerated, and symptoms resolved with withdrawal of pembrolizumab and steroid administration for another medical reason.
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spelling pubmed-67916162019-11-15 A Celiac Disease Phenotype After Checkpoint Inhibitor Exposure: An Example of Immune Dysregulation After Immunotherapy Arnouk, Joud Mathew, Don Nulton, Ethan Rachakonda, Vikrant ACG Case Rep J Case Report Celiac disease is characterized by duodenal inflammation after exposure to gluten. Checkpoint inhibitors are antibodies that inhibit the inhibitory signals of the cytotoxic T lymphocytes to enhance antitumor responses. A 79-year-old man with an unknown history of celiac disease underwent treatment with pembrolizumab for recurrent left maxillary melanoma. He subsequently developed diarrhea and weight loss. Serology was positive for anti-tissue transglutaminase immunoglobulin A. Upper endoscopy revealed duodenal villous atrophy, which was confirmed on biopsy. A gluten-free diet was not tolerated, and symptoms resolved with withdrawal of pembrolizumab and steroid administration for another medical reason. Wolters Kluwer 2019-08-08 /pmc/articles/PMC6791616/ /pubmed/31737699 http://dx.doi.org/10.14309/crj.0000000000000158 Text en © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Arnouk, Joud
Mathew, Don
Nulton, Ethan
Rachakonda, Vikrant
A Celiac Disease Phenotype After Checkpoint Inhibitor Exposure: An Example of Immune Dysregulation After Immunotherapy
title A Celiac Disease Phenotype After Checkpoint Inhibitor Exposure: An Example of Immune Dysregulation After Immunotherapy
title_full A Celiac Disease Phenotype After Checkpoint Inhibitor Exposure: An Example of Immune Dysregulation After Immunotherapy
title_fullStr A Celiac Disease Phenotype After Checkpoint Inhibitor Exposure: An Example of Immune Dysregulation After Immunotherapy
title_full_unstemmed A Celiac Disease Phenotype After Checkpoint Inhibitor Exposure: An Example of Immune Dysregulation After Immunotherapy
title_short A Celiac Disease Phenotype After Checkpoint Inhibitor Exposure: An Example of Immune Dysregulation After Immunotherapy
title_sort celiac disease phenotype after checkpoint inhibitor exposure: an example of immune dysregulation after immunotherapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791616/
https://www.ncbi.nlm.nih.gov/pubmed/31737699
http://dx.doi.org/10.14309/crj.0000000000000158
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