Upper Gastrointestinal Tract IrAEs: A Case Report About Sintilimab-Induced Acute Erosive Hemorrhagic Gastritis
IntroductionImmune checkpoint inhibitors (ICIs) have now become the standard therapy for malignancies like non-small cell lung cancer and classical Hodgkin’s lymphoma. ICIs are associated with unique immune-related adverse events (irAEs) caused by dysregulated immune activation. Treatment of lower g...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.840916/full |
| _version_ | 1818533585562370048 |
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| author | Qi Ai Wen Chen Yonggui Li Guoqing Li |
| author_facet | Qi Ai Wen Chen Yonggui Li Guoqing Li |
| author_sort | Qi Ai |
| collection | DOAJ |
| description | IntroductionImmune checkpoint inhibitors (ICIs) have now become the standard therapy for malignancies like non-small cell lung cancer and classical Hodgkin’s lymphoma. ICIs are associated with unique immune-related adverse events (irAEs) caused by dysregulated immune activation. Treatment of lower gastrointestinal (GI) tract irAEs, such as colitis, is more common. However, for upper gastrointestinal tract irAEs, there is a lack of consensus in terms of globally standardized disease classification and treatment guidelines. Here, we report a case of sintilimab-induced acute erosive hemorrhagic gastritis.Case PresentationA 54-year-old man with metastatic NSCLC (PT2N2M1 stage IV) underwent treatment with eight courses of sintilimab + bevacizumab, followed by maintenance therapy with sintilimab alone. However, he presented with epigastric pain and melena at the end of the first sintilimab treatment, and the symptoms occurred repeatedly after regular treatment with acute erosive hemorrhagic gastritis. Repeat esophagogastroduodenoscopy (EGD) showed severe hemorrhagic gastritis; symptomatic relief and improvement in EGD images were noted for as long as he was being treated with steroids, methylprednisolone sodium.ConclusionAs far as we are aware, we here describe the first case of sintilimab-associated acute erosive hemorrhagic gastritis, an upper gastrointestinal toxicity event. Throughout the treatment progression, differential diagnosis, multidisciplinary discussion, and the use of immunosuppressants were instrumental in clarifying the diagnosis and were crucial to the prognosis of the patient and continued treatment with ICIs. |
| first_indexed | 2024-12-11T18:00:40Z |
| format | Article |
| id | doaj.art-e6d4d02e335846a48f170850f725bcff |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-11T18:00:40Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-e6d4d02e335846a48f170850f725bcff2022-12-22T00:55:53ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-06-011310.3389/fimmu.2022.840916840916Upper Gastrointestinal Tract IrAEs: A Case Report About Sintilimab-Induced Acute Erosive Hemorrhagic GastritisQi AiWen ChenYonggui LiGuoqing LiIntroductionImmune checkpoint inhibitors (ICIs) have now become the standard therapy for malignancies like non-small cell lung cancer and classical Hodgkin’s lymphoma. ICIs are associated with unique immune-related adverse events (irAEs) caused by dysregulated immune activation. Treatment of lower gastrointestinal (GI) tract irAEs, such as colitis, is more common. However, for upper gastrointestinal tract irAEs, there is a lack of consensus in terms of globally standardized disease classification and treatment guidelines. Here, we report a case of sintilimab-induced acute erosive hemorrhagic gastritis.Case PresentationA 54-year-old man with metastatic NSCLC (PT2N2M1 stage IV) underwent treatment with eight courses of sintilimab + bevacizumab, followed by maintenance therapy with sintilimab alone. However, he presented with epigastric pain and melena at the end of the first sintilimab treatment, and the symptoms occurred repeatedly after regular treatment with acute erosive hemorrhagic gastritis. Repeat esophagogastroduodenoscopy (EGD) showed severe hemorrhagic gastritis; symptomatic relief and improvement in EGD images were noted for as long as he was being treated with steroids, methylprednisolone sodium.ConclusionAs far as we are aware, we here describe the first case of sintilimab-associated acute erosive hemorrhagic gastritis, an upper gastrointestinal toxicity event. Throughout the treatment progression, differential diagnosis, multidisciplinary discussion, and the use of immunosuppressants were instrumental in clarifying the diagnosis and were crucial to the prognosis of the patient and continued treatment with ICIs.https://www.frontiersin.org/articles/10.3389/fimmu.2022.840916/fullsintilimabimmune checkpoint inhibitoracute erosive hemorrhagic gastritisimmune-related adverse eventupper gastrointestinal tract irAE |
| spellingShingle | Qi Ai Wen Chen Yonggui Li Guoqing Li Upper Gastrointestinal Tract IrAEs: A Case Report About Sintilimab-Induced Acute Erosive Hemorrhagic Gastritis Frontiers in Immunology sintilimab immune checkpoint inhibitor acute erosive hemorrhagic gastritis immune-related adverse event upper gastrointestinal tract irAE |
| title | Upper Gastrointestinal Tract IrAEs: A Case Report About Sintilimab-Induced Acute Erosive Hemorrhagic Gastritis |
| title_full | Upper Gastrointestinal Tract IrAEs: A Case Report About Sintilimab-Induced Acute Erosive Hemorrhagic Gastritis |
| title_fullStr | Upper Gastrointestinal Tract IrAEs: A Case Report About Sintilimab-Induced Acute Erosive Hemorrhagic Gastritis |
| title_full_unstemmed | Upper Gastrointestinal Tract IrAEs: A Case Report About Sintilimab-Induced Acute Erosive Hemorrhagic Gastritis |
| title_short | Upper Gastrointestinal Tract IrAEs: A Case Report About Sintilimab-Induced Acute Erosive Hemorrhagic Gastritis |
| title_sort | upper gastrointestinal tract iraes a case report about sintilimab induced acute erosive hemorrhagic gastritis |
| topic | sintilimab immune checkpoint inhibitor acute erosive hemorrhagic gastritis immune-related adverse event upper gastrointestinal tract irAE |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.840916/full |
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