Gastrointestinal: Recurrence of pembrolizumab‐induced severe gastritis after tapering steroid therapy

Okubo, Yu; Hosotani, Kazuya; Taniguchi, Yushi; Hara, Shigeo; Inokuma, Tetsuro

doi:10.1111/jgh.15248

Cited by 3 publications

(3 citation statements)

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“…Hence, we cannot prove or disprove pre-existing type B or C gastritis but, considering all findings and the patient's history, a relevant type B or C gastritis seem unlikely, and the histological findings are like those in other published cases that are considered irAEs of pembrolizumab. They are described in varying degrees of similarity with our case, but a small number of cases are extremely similar in their description of macroscopic and histological findings [15,17,18,21]. The outstanding feature hereby is the complete destruction of the gastric epithelium with the absence of mucosal glands.…”

Section: Discussionsupporting

confidence: 67%

“…They are described in varying degrees of similarity with our case, but a small number of cases are extremely similar in their description of macroscopic and histological findings [15,17,18,21]. The outstanding feature hereby is the complete destruction of the gastric epithelium with the absence of mucosal glands.…”

Section: Discussionsupporting

confidence: 67%

“…So far, few case reports described the exact same histological pattern with the complete destruction of the glandular epithelium [15,17,18,21].…”

Section: Discussionmentioning

confidence: 82%

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Immune-mediated Gastritis in a Patient with metastatic Lung Cancer due to Therapy with the immune Checkpoint Inhibitor Pembrolizumab – Differences and Similarities in Comparison to “endogenous” autoimmune Type A Gastritis and a review of literature

2023

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Immune checkpoint inhibitors are increasingly used in advanced malignant diseases and are well-known for their good results. With the blockade of immune checkpoints, the probability of immune-related adverse events is also increased.We present a 54-year-old female patient with advanced NSCLC. She was treated with pembrolizumab and developed a stable disease under therapy. After six cycles, she presented with massive epigastric pain to our emergency department. Gastroscopy showed severe erosive-fibrinous pangastritis without the involvement of the esophagus, duodenum, or other immune-related adverse effects. Histology showed the complete destruction of the gastric mucosa. We concluded an immune-mediated gastritis by pembrolizumab, after the exclusion of other differential diagnoses.Despite treatment with prednisolone and marked improvement of her symptoms, the mucosa was never fully reconstituted into a healthy mucosa.Furthermore, we collected published reports of similar cases and conducted a comparison with features of a typical, endogenous type A gastritis to highlight similarities and differences.

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Section: Discussionsupporting

confidence: 67%