Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report

Autor: Julie Leblanc, Solene Hoibian, Agathe Boucraut, Jean-Philippe Ratone, Louis Stoffaes, Domitille Dano, Delphine Louvel-Perrot, Brice Chanez, Anne-Sophie Chretien, Anne Madroszyk, Philippe Rochigneux
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Frontiers in Immunology, Vol 12 (2021)
Druh dokumentu: article
ISSN: 1664-3224
DOI: 10.3389/fimmu.2021.799666
Popis: 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.
Databáze: Directory of Open Access Journals