Dual checkpoint inhibitor-associated eosinophilic enteritis

J Immunother Cancer. 2019 Nov 15;7(1):310. doi: 10.1186/s40425-019-0743-5.

Abstract

Background: Eosinophilia has been reported as a rare, new biological effect of immune checkpoint inhibition that may be associated with improved treatment response and the development of immune-related adverse events.

Case presentation: We report a case of dual checkpoint inhibitor-associated hypereosinophilia and eosinophilic enteritis in a patient with advanced cutaneous melanoma. Rapid resolution of peripheral eosinophilia and associated symptoms was achieved with steroids alone.

Conclusions: Immune checkpoint inhibition can trigger inflammation in virtually any organ in the body, leading to diverse clinical manifestations. To our knowledge, this is the first case report of eosinophilic enteritis due to ipilimumab plus nivolumab.

Keywords: Checkpoint inhibition; Eosinophilia; Eosinophilic enteritis; Melanoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Enteritis / chemically induced*
  • Enteritis / drug therapy
  • Eosinophilia / chemically induced*
  • Eosinophilia / drug therapy
  • Gastritis / chemically induced*
  • Gastritis / drug therapy
  • Humans
  • Ipilimumab / adverse effects*
  • Male
  • Melanoma / drug therapy
  • Nivolumab / adverse effects*
  • Prednisone / therapeutic use
  • Skin Neoplasms / drug therapy

Substances

  • Antineoplastic Agents, Immunological
  • Ipilimumab
  • Nivolumab
  • Prednisone

Supplementary concepts

  • Eosinophilic enteropathy