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Immune checkpoint inhibitor refractory colitis leading to total colectomy in a melanoma patient

Journal Volume 86 - 2023
Issue Fasc.2 - Case reports
Author(s) N. Baczewska 1 #, M. Philippart 1 #, J. Siplet 1, J-F. Baurain 2, L. Stainier 3, E. Laterre 4, L. Duck 5, J-C. Coche 1
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Full Article
PAGES 371-373
(1) Division of Gastroenterology, Clinique Saint-Pierre, Ottignies-Louvain-La-Neuve, Belgium
(2) Division of Oncology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
(3) Division of Surgery, Clinique Saint-Pierre, Ottignies-Louvain-La-Neuve, Belgium
(4) Division of Anatomical pathology, Institute of Pathology and Genetics, Gosselies, Belgium
(5) Division of Oncology, Clinique Saint-Pierre, Ottignies-Louvain-La-Neuve, Belgium
(#) Contributed equally

Immunotherapy is becoming more and more relevant in the treatment of advanced melanoma. Proper management of its side effects can prevent severe complications. We describe the case of a 73-year-old patient with severe refractory colitis secondary to immunotherapy. The patient has been treated for 6 months with Nivolumab, an anti-PD-1, as adjuvant therapy for locally advanced melanoma. He was admitted to the hospital with a deteriorating general condition associated with severe diarrhea and rectal bleeding for 3 weeks. Despite three lines of treatment (high dose corticosteroids, infliximab, mycophenolate mofetil), the patient still presented clinical and endoscopic colitis, with additional infectious complications. The patient required surgical management for total colectomy. In this article we present one of the rare cases of autoimmune colitis that did not respond to various immunosuppressive treatments and required surgery.

Keywords: melanoma, immune checkpoint inhibitor, colitis, colectomy.

The authors declare that they have no conflict of interest.
© Acta Gastro-Enterologica Belgica.
PMID 37428174