CMV coinfection in treatment refractory immune checkpoint inhibitor colitis

Kevin B Harris; Pauline Funchain; Brian B Baggott

doi:10.1136/bcr-2019-233519

CMV coinfection in treatment refractory immune checkpoint inhibitor colitis

BMJ Case Rep. 2020 May 19;13(5):e233519. doi: 10.1136/bcr-2019-233519.

Authors

Kevin B Harris¹, Pauline Funchain², Brian B Baggott³

Affiliations

¹ Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA harrisk5@ccf.org.
² Department of Hematology and Oncology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
³ Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Abstract

As immune checkpoint inhibitors (ICIs) are increasingly used, clinicians are more frequently encountering the side effects of these therapies. ICIs have been implicated in numerous adverse effects against healthy tissues. We present a case of a patient who developed treatment refractory checkpoint inhibitor colitis. Following colonoscopy, it was discovered that this patient had cytomegalovirus (CMV) coinfection. This case report highlights the importance of undertaking an appropriate assessment, including endoscopic and histologic investigation, of patients with presumed ICI colitis. Accurately diagnosing a superimposed CMV colitis changes clinical management and can improve patient outcomes.

Keywords: gastroenterology; hepatitis and other GI infections; oncology.

Publication types

Case Reports

MeSH terms

Aged
Antineoplastic Agents, Immunological / adverse effects
Colitis / chemically induced*
Colitis / diagnosis*
Colitis / drug therapy
Colonoscopy
Comorbidity
Cytomegalovirus / isolation & purification
Cytomegalovirus Infections / diagnosis*
Cytomegalovirus Infections / drug therapy
Humans
Immune Checkpoint Inhibitors / adverse effects*
Male
Treatment Outcome

Substances

Antineoplastic Agents, Immunological
Immune Checkpoint Inhibitors