CMV coinfection in treatment refractory immune checkpoint inhibitor colitis

BMJ Case Rep. 2020 May 19;13(5):e233519. doi: 10.1136/bcr-2019-233519.

Abstract

As immune checkpoint inhibitors (ICIs) are increasingly used, clinicians are more frequently encountering the side effects of these therapies. ICIs have been implicated in numerous adverse effects against healthy tissues. We present a case of a patient who developed treatment refractory checkpoint inhibitor colitis. Following colonoscopy, it was discovered that this patient had cytomegalovirus (CMV) coinfection. This case report highlights the importance of undertaking an appropriate assessment, including endoscopic and histologic investigation, of patients with presumed ICI colitis. Accurately diagnosing a superimposed CMV colitis changes clinical management and can improve patient outcomes.

Keywords: gastroenterology; hepatitis and other GI infections; oncology.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents, Immunological / adverse effects
  • Colitis / chemically induced*
  • Colitis / diagnosis*
  • Colitis / drug therapy
  • Colonoscopy
  • Comorbidity
  • Cytomegalovirus / isolation & purification
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Male
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological
  • Immune Checkpoint Inhibitors