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Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report
Immune checkpoint inhibitors (ICI) reinvigorate the immune system to recognize and destroy tumor cells. Because of this biological mechanism, patients might develop autoimmune toxicities, notably in the digestive tract (most frequently, hepatitis or colitis). A 70-year-old man with relapsed mesothel...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718638/ https://www.ncbi.nlm.nih.gov/pubmed/34975913 http://dx.doi.org/10.3389/fimmu.2021.799666 |
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author | Leblanc, Julie Hoibian, Solene Boucraut, Agathe Ratone, Jean-Philippe Stoffaes, Louis Dano, Domitille Louvel-Perrot, Delphine Chanez, Brice Chretien, Anne-Sophie Madroszyk, Anne Rochigneux, Philippe |
author_facet | Leblanc, Julie Hoibian, Solene Boucraut, Agathe Ratone, Jean-Philippe Stoffaes, Louis Dano, Domitille Louvel-Perrot, Delphine Chanez, Brice Chretien, Anne-Sophie Madroszyk, Anne Rochigneux, Philippe |
author_sort | Leblanc, Julie |
collection | PubMed |
description | Immune checkpoint inhibitors (ICI) reinvigorate the immune system to recognize and destroy tumor cells. Because of this biological mechanism, patients might develop autoimmune toxicities, notably in the digestive tract (most frequently, hepatitis or colitis). A 70-year-old man with relapsed mesothelioma was treated with nivolumab in 3rd line. He was hospitalized for watery and foul-smelling diarrhea. He underwent gastrointestinal endoscopy, showing duodenitis and villous atrophy and measurement of serum IgA antibodies to tissue transglutaminase (tTG-IgA+), leading to the diagnosis of ICI-induced celiac disease. He was treated with steroids, proton pump inhibitors, and a gluten-free diet. If ICI-induced celiac disease is rare in the literature, increasing reports suggest that celiac disease might represent an underestimated ICI toxicity. This case highlights the necessity of complementary investigation (including tTG-IgA and endoscopic biopsies) in patients with atypical digestive symptoms during immunotherapy. |
format | Online Article Text |
id | pubmed-8718638 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87186382022-01-01 Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report Leblanc, Julie Hoibian, Solene Boucraut, Agathe Ratone, Jean-Philippe Stoffaes, Louis Dano, Domitille Louvel-Perrot, Delphine Chanez, Brice Chretien, Anne-Sophie Madroszyk, Anne Rochigneux, Philippe Front Immunol Immunology Immune checkpoint inhibitors (ICI) reinvigorate the immune system to recognize and destroy tumor cells. Because of this biological mechanism, patients might develop autoimmune toxicities, notably in the digestive tract (most frequently, hepatitis or colitis). A 70-year-old man with relapsed mesothelioma was treated with nivolumab in 3rd line. He was hospitalized for watery and foul-smelling diarrhea. He underwent gastrointestinal endoscopy, showing duodenitis and villous atrophy and measurement of serum IgA antibodies to tissue transglutaminase (tTG-IgA+), leading to the diagnosis of ICI-induced celiac disease. He was treated with steroids, proton pump inhibitors, and a gluten-free diet. If ICI-induced celiac disease is rare in the literature, increasing reports suggest that celiac disease might represent an underestimated ICI toxicity. This case highlights the necessity of complementary investigation (including tTG-IgA and endoscopic biopsies) in patients with atypical digestive symptoms during immunotherapy. Frontiers Media S.A. 2021-12-17 /pmc/articles/PMC8718638/ /pubmed/34975913 http://dx.doi.org/10.3389/fimmu.2021.799666 Text en Copyright © 2021 Leblanc, Hoibian, Boucraut, Ratone, Stoffaes, Dano, Louvel-Perrot, Chanez, Chretien, Madroszyk and Rochigneux https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Leblanc, Julie Hoibian, Solene Boucraut, Agathe Ratone, Jean-Philippe Stoffaes, Louis Dano, Domitille Louvel-Perrot, Delphine Chanez, Brice Chretien, Anne-Sophie Madroszyk, Anne Rochigneux, Philippe Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report |
title | Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report |
title_full | Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report |
title_fullStr | Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report |
title_full_unstemmed | Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report |
title_short | Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report |
title_sort | celiac disease after administration of immune checkpoint inhibitors: a case report |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718638/ https://www.ncbi.nlm.nih.gov/pubmed/34975913 http://dx.doi.org/10.3389/fimmu.2021.799666 |
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