Nivolumab‐induced celiac‐like enteropathy in patient with metastatic renal cell carcinoma: Case report and review of the literature

Duval, Lucie; Habes, Sarah; Chatellier, Thierry; Guerzider, P; Bossard, Céline; Masliah, Claude; Archambeaud, Isabelle; Touchefeu, Yann; Matysiak‐Budnik, Tamara

doi:10.1002/ccr3.2342

Cited by 10 publications

(5 citation statements)

References 24 publications

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“…To our knowledge, only one case of early onset immune-induced celiac disease was reported to date on anti-programmed cell death protein 1 therapy for a metastatic renal carcinoma. 6 Coherently with this report, we observed an association with an autoimmune dysthyroidia and a negativity for specific celiac disease antibodies. Our patient presented a chronic form of celiac disease over several months with a delayed onset, which was associated with an exocrine pancreatic insufficiency.…”

Section: To the Editorsupporting

confidence: 85%

Coeliac-Like Disease Is a Rare Immune-Related Complication Induced by Nivolumab in NSCLC

Kokorian

Grainville

Robert

et al. 2020

Journal of Thoracic Oncology

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Section: To the Editorsupporting

confidence: 85%

Coeliac-Like Disease Is a Rare Immune-Related Complication Induced by Nivolumab in NSCLC

Kokorian

Grainville

Robert

et al. 2020

Journal of Thoracic Oncology

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“…CPI injury of the duodenum and small bowel has been described in small case series 12,15 and occasional case reports. [20][21][22][23] The most frequent endoscopic abnormality was erythematous mucosa. Other occasional findings reported were erosions, flattening, stricture, exudate, and ulcers.…”

Section: Duodenum and Small Bowelmentioning

confidence: 99%

Pathologic Manifestations of Gastrointestinal and Hepatobiliary Injury in Immune Checkpoint Inhibitor Therapy

Patil

Zhang

2020

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Immune checkpoint inhibitors (CPIs), including cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitors and the programmed death receptor-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors, are being increasingly used for treating many advanced malignancies. However, CPI therapy is also associated with gastrointestinal and hepatobiliary adverse effects. Objectives.— To review the adverse effects of CPI therapy on the gastrointestinal tract and hepatobiliary system. To describe histopathologic patterns and discuss differential diagnostic considerations in the diagnosis of CPI injuries. Data Sources.— Published peer-reviewed literature in the English language and personal experience in the diagnosis of CPI injuries. Conclusions.— The pathologic manifestations of CPI therapy–induced gastrointestinal and hepatobiliary injury are broad. The patterns of esophageal CPI injury include lymphocytic inflammation and ulcerative esophagitis, while those of gastric injury include chronic active gastritis, lymphocytic gastritis, focal enhancing gastritis, and periglandular inflammation. The duodenal injury may present as duodenitis with villous blunting and granulomas. We also noticed active colitis, microscopic colitis, chronic active colitis, increased apoptosis, ischemic colitis, and nonspecific inflammatory reactive changes in colonic injuries. The reported histologic features of hepatobiliary injuries are panlobular hepatitis, centrilobular necrosis, portal inflammation with bile duct injury, steatosis, nodular regenerative hyperplasia, and secondary sclerosing cholangitis. In summary, we here discuss the pathologic features and differential diagnosis of CPI therapy–induced gastrointestinal and hepatobiliary injury. Recognition of CPI injury is important to determine the proper management that often includes cessation of CPI therapy; and administration of steroids or other immunosuppressive agents, based on severity of injury.

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“…Based on our predefined inclusion criteria, the literature search identified ten papers in the period 2013–2021. While two of them were original papers, the remaining ones were either case reports or letters to the editor [ 33 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. Overall, twenty-five patients were described in these publications with eleven of them receiving a diagnosis of CD confirmed by serological and histological assessment.…”

Section: Resultsmentioning

confidence: 99%

Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists

et al. 2022

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Immune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), programmed cell death protein (PD-1), and its ligand PDL-1, are finding increasing application in the treatment of malignant neoplasms. The widespread clinical use of these drugs, however, resulted in the discovery of side effects. The occurrence of celiac disease (CD) after ICIs therapy has been reported in the literature, but its incidence remains unknown and the role of ICIs in its onset is not yet clear. In this review, we examine the published data on this topic in order to better understand and define this entity from a histological point of view. We performed an electronic literature search to identify original reports in which CD or pathological CD-like conditions were documented histologically in patients treated with ICIs. We identified ten papers. A total of twenty-five patients were included in these publications, eleven of them receiving a serologic and histological diagnosis of CD, and four a histological diagnosis of CD-like conditions, in which pathogenesis appears to be multifactorial. ICIs can cause a CD-like enteropathy and biopsies with clinical integration are crucial to diagnose this condition. CD rarely has been observed during treatment with ICIs and its morphological aspects are similar to ICIs-CD enteropathy. Moreover, the onset of ICIs-CD may have a distinct immune mechanism compared to classical CD. Thus, the pathologists must make a histological diagnosis of CD with caution and only in adequate clinical and serological context.

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Nivolumab‐induced celiac‐like enteropathy in patient with metastatic renal cell carcinoma: Case report and review of the literature

Cited by 10 publications

References 24 publications

Coeliac-Like Disease Is a Rare Immune-Related Complication Induced by Nivolumab in NSCLC

Coeliac-Like Disease Is a Rare Immune-Related Complication Induced by Nivolumab in NSCLC

Pathologic Manifestations of Gastrointestinal and Hepatobiliary Injury in Immune Checkpoint Inhibitor Therapy

Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists

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