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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
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.
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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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