Severe inflammatory ileitis resulting in ileal perforation in association with combination immune checkpoint blockade for metastatic malignant melanoma

BMJ Case Rep. 2018 Apr 5:2018:bcr2018224913. doi: 10.1136/bcr-2018-224913.

Abstract

Immune checkpoint inhibitors have become standard of care in metastatic malignant melanoma management. Despite superior effectiveness to chemotherapy, significant immune-related adverse events (irAE) may occur, particularly if used in combination. Gastrointestinal irAEs were reported with different patterns of involvement. Here, we report the case of a patient who had ileal perforation as a complication of terminal ileitis, without colitis, induced by combination immune checkpoint blockade.

Keywords: malignant disease and immunosuppression; radiology; skin cancer; small intestine; unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Drug Therapy, Combination / adverse effects*
  • Female
  • Humans
  • Ileitis / chemically induced*
  • Ileitis / complications
  • Intestinal Perforation / chemically induced*
  • Intestinal Perforation / therapy
  • Ipilimumab / adverse effects*
  • Melanoma / drug therapy*
  • Middle Aged
  • Treatment Outcome
  • Vulvar Neoplasms / drug therapy*

Substances

  • Antineoplastic Agents
  • Ipilimumab