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An Autopsy Case of Nivolumab-induced Colitis Shunichi Yanai 1 , Keisuke Kawasaki 1 , Shotaro Nakamura 1 , Yasuko Fujita 2 , Jhunichi Ogawa 3 , Tamotsu Sugai 2 , Takayuki Matsumoto 1 1Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan 2Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Iwate, Japan 3Department of Internal Medicine, Kitakami Saiseikai Hospital, Kitakami, Japan Keyword: 免疫チェックポイント阻害薬 , ニボルマブ , インフリキシマブ , 免疫チェックポイント阻害薬関連副作用 , irAE pp.1593-1601
Published Date 2021/11/25
DOI https://doi.org/10.11477/mf.1403202604
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 A 60s man with advanced lung squamous cell carcinoma was treated with nivolumab, an immune checkpoint inhibitor. The patient was admitted to our hospital with diarrhea, hematochezia, and abdominal pain. Colonoscopy revealed friable erythematous mucosa and ulceration from the rectum to sigmoid colon. These findings were compatible with ulcerative colitis. Nivolumab-induced colitis, an immune-related adverse effect, was diagnosed. The patient was treated with prednisolone and infliximab, but he did not respond. The patient died 173 days after the first administration of nivolumab. A pathological autopsy was done. According to the autopsy, the lung tumor size was 8cm, with 70% necrosis. The effect of the immune checkpoint inhibitor was confirmed. However, the colitis grade score was severe because of the circumferential ulcer and pseudopolyposis of the distal colon. The number of cases of nivolumab-induced colitis is expected to increase because of the extension of indications.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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