Published online Jun 15, 2020. doi: 10.4251/wjgo.v12.i6.699
Peer-review started: January 18, 2020
First decision: April 16, 2020
Revised: May 7, 2020
Accepted: May 19, 2020
Article in press: May 19, 2020
Published online: June 15, 2020
Colitis is one of the immune-related side effects of immunotherapy. Usually, such type of side effect was reported to develop within a few weeks of treatment initiation, our case started within a few days.
We present a case of a 37-year-old gentleman with bright red loose stools, abdominal pain, and tenesmus. A diagnosis of colitis was made based on endoscopic and histologic findings. Treatment was thereafter continued with oral steroids and discontinuation of the immunotherapy medications. Symptoms resolved after starting the treatment and the patient continued to be symptom-free on subsequent follow-up. The unique about this case report is that the patient developed bloody diarrhea within five days of the 1st immunotherapy cycle, and the patient was on combined ipilimumab and nivolumab.
Immunotherapy related complications might occur within days from being on immunotherapy; we need more research to open the way for future pathological and clinical research to further understand the pathophysiology behind it.
Core tip: Immunotherapy is one of the novel treatments of this century, though it can cause many predicted and unpredicted immune-related side effects. This is a rare case of immunotherapy induced colitis in an otherwise healthy male who was recently diagnosed with melanoma and was started on appropriate immunotherapy treatment. Clinicians should keep in mind the possible immune side effects of immune checkpoint inhibitors as they can develop at any stage, which will help physicians in stopping these medications earlier and avoiding further serious harm.