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Severe steroid refractory gastritis induced by Nivolumab: A case report

Authors: Vindum, Helene Hjorth; Agnholt, Jørgen S.; Nielsen, Anders Winther Moelby; Nielsen, Mette Bak; Schmidt, Henrik;

Severe steroid refractory gastritis induced by Nivolumab: A case report

Abstract

Immune checkpoint inhibitors are widely used for treatment of many advanced malignancies. Lower gastrointestinal (GI) side effects, such as diarrhea and colitis, are common, but upper GI side effects are rarely reported. Consequently, the correct treatment of upper GI adverse events has been less frequently described.We describe a case of a 16-year-old woman with stage IIIb malignant melanoma treated with adjuvant monotherapy using Nivolumab. The patient developed severe gastritis after six series of Nivolumab with weight loss, nausea, and vomiting. There was no effect of intravenous steroids, but the patient´s condition resolved after administration of Infliximab.This case report supports the same treatment for gastritis as for colitis, which is in line with current guidelines.

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Keywords

Melanoma/immunology, Skin Neoplasms, Adolescent, Skin Neoplasms/immunology, Drug Resistance, Case Report, Gastritis/diagnosis, Severity of Illness Index, Immune checkpoint inhibitors, Chemotherapy, Adjuvant/adverse effects, Glucocorticoids/pharmacology, Immune Checkpoint Inhibitors/adverse effects, Immune-related adverse events, Case report, Humans, Glucocorticoids, Immune Checkpoint Inhibitors, Melanoma, Nivolumab/adverse effects, Infliximab, Infliximab/therapeutic use, Nivolumab, Treatment Outcome, Chemotherapy, Adjuvant, Gastritis, Female

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    popularity
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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
20
Top 10%
Top 10%
Top 10%
Green
gold