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2024 ; 16
(7
): 2329-2336
Nephropedia Template TP
gab.com Text
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English Wikipedia
Multidisciplinary management of ulcerative colitis complicated by immune
checkpoint inhibitor-associated colitis with life-threatening gastrointestinal
hemorrhage: A case report
#MMPMID39087117
Hong N
; Wang B
; Zhou HC
; Wu ZX
; Fang HY
; Song GQ
; Yu Y
World J Gastrointest Surg
2024[Jul]; 16
(7
): 2329-2336
PMID39087117
show ga
BACKGROUND: Programmed cell death 1 (PD-1) inhibitors are immune checkpoint
inhibitors (ICI) that have demonstrated significant efficacy in treating various
advanced malignant tumors. While most patients tolerate treatment well, several
adverse drug reactions, such as fatigue, myelosuppression, and ICI-associated
colitis, have been reported. CASE SUMMARY: This case involved a 57-year-old male
patient with ulcerative colitis complicated by hepatocarcinoma who underwent
treatment with tirelizumab (a PD-1 inhibitor) for six months. The treatment led
to repeated life-threatening lower gastrointestinal hemorrhage. The patient
received infliximab, vedolizumab, and other salvage procedures but ultimately
required subtotal colectomy due to uncontrollable massive lower gastrointestinal
bleeding. Currently, postoperative gastrointestinal bleeding has stopped, the
patient's stool has turned yellow, and his full blood cell count has returned to
normal. CONCLUSION: This case highlights the necessity of early identification,
timely and adequate treatment of ICI-related colitis, and rapid escalation to
achieve the goal of improving prognosis.