Checking Out the Associations Between Inflammatory Bowel Disease and Checkpoint Inhibitor Colitis

Excerpt

A 56-year-old man with a history of advanced metastatic melanoma was evaluated for ongoing diarrhea and urgency. Diarrhea, described as multiple loose bowel movements a day with occasional blood, had started 5 years earlier after undergoing immunotherapy with four cycles of ipilimumab. He had no prior history of gastrointestinal issues but did have a family history of a mother with ulcerative colitis. Though symptoms improved without completely abating after ipilimumab was discontinued, he resumed immunotherapy with nivolumab to complete ten total cycles. Diarrhea recurred and worsened with up to 10 bowel movements a day, eventuating in hospitalization for dehydration with acute kidney injury, at which time a computerized tomography (CT) scan showed diffuse colitis. He was treated with intravenous steroids and discharged on a prednisone taper, but continued to have milder, ongoing loose bowel movements with urgency. …