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Scientific letter
Nivolumab-induced acute neutrophilic gastritis: Case report in a tertiary hospital
Gastritis aguda inducida por nivolumar: a propósito de una serie de casos recogidos en un hospital terciario
Asunción Ojeda Gómeza,
Corresponding author
asunojedagomez@gmail.com

Corresponding author.
, Maria Isabel Pamies Ramónb, Alicia Brotons Brotonsa, Nuria Jiménez Garcíaa, Maria Dolores Picó Salaa, María Cabezas Macianc, Javier Sola Vera Sáncheza, Mariana Fe García Sepulcrea
a General University Hospital of Elche, Digestive Care Service, Elche, Alicante, Spain
b General University Hospital of Elche, Oncology Service, Elche, Alicante, Spain
c General University Hospital of Elche, Anatomopathology Service, Elche, Alicante, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Immune check-point blockade agents have become the standard of care for an increasing number of indications over the last few years&#46; These drugs are associated with immune-related adverse events &#40;irAEs&#41; whose incidence varies depending on the immune check-points which are being inhibited&#46; Gastrointestinal toxicity from cancer immunotherapy appears to be more frequent for anti-CTLA-4 than for anti-PD1 or anti-PD-L1&#44; the target of Nivolumab&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Although irAEs including the lower gastrointestinal tract are well known in anti-PD1 treatment&#59; the gastritis or the esophagitis remain sporadic effects&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> In our center&#44; two cases of acute pangastritis have been reported in one year&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We carried out a retrospective&#44; descriptive study&#46; We reviewed the clinical history of those patients who had received Nivolumab for any indication from January 2017 to December 2021 in our tertiary center&#46; We selected those with upper gastrointestinal symptoms and for whom an upper gastrointestinal diagnosis had been reached by an esophagogastroduodenoscopy &#40;OGD&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Of the overall 100 patients treated with Nivolumab in this period&#44; two cases of gastritis were detected&#44; which supposes an incidence rate of 2&#37; &#40;IC 95&#37; &#8722;0&#46;007&#44; 0&#46;047&#41;&#46; The first patient was a 47 years-aged man with a personal history of malignant non-metastatic melanoma &#40;pT3bN2M0&#41; radically removed&#46; He underwent adjuvant therapy with Nivolumab for recurrence prevention and was admitted to our ward with epigastric pain and hyporexia&#46; The second patient was a 64 year-old woman diagnosed with a metastatic choroidal melanoma previously treated with local surgery who reported epigastric pain in the last month&#46; In both cases the symptoms started just after receiving the 9th dose of treatment which corresponds to 4&#46;5 months follow-up period&#46; Their basal characteristics are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; For the two cases&#44; preferential ODG were performed&#44; showing an intense inflammation throughout the stomach&#46; Macroscopically&#44; the mucosa was erythematous&#44; edematous&#44; with friability and extense ulcerations covered with fibrine&#46; In both cases the biopsies taken revealed inflammatory neutrophilic infiltration into the epithelium&#44; as well as cellular apoptosis and crypt microabscesses&#44; all of which was related to Nivolumab drug-induced pangastritis&#46; No form of Helicobacter Pylori was identified in any case&#46; CMV determinations by IHQ and biopsies were also negative&#46; Medical treatment with double-dose of proton-pump inhibitor and definitive cessation of Nivolumab was established&#44; becoming the first patient rapidly asymptomatic&#46; However our second patient didn&#8217;t show any improvement after several weeks of oral treatment so she remained hospitalized with IV corticosteroids&#44; observing a complete remission of his symptoms&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Nivolumab is a PD-L1 inhibitor extendedly used in metastatic&#44; locally advanced or recurrent malignant diseases such as melanoma&#44; non-small-cell lung cancer&#44; renal cell or urothelial carcinoma&#44; Hodgkin&#39;s disease&#44; and squamous cell carcinoma of the head and neck&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It leads to the activation of the cytotoxic immune response which is normally carried out by LT-CD8 against malignant cells&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The immune-mediated gastritis is a rare adverse event&#44; which can appear several months after the beginning of the treatment but also after its discontinuation&#46; The differential diagnosis must be reached by excluding infectious gastritis&#44; vasculitis&#44; Crohn&#39;s disease or Beh&#231;et syndrome&#46; The pathologist must always know the involvement of this treatment in order to achieve a reliable diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> The role of Helicobater Pylori must be highlighted in this case&#46; Since it is capable of simulating or even worsening the immune mediated gastritis&#44; not only its identification but also its eradication becomes essential&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> The treatment is based on the immediate cessation of the immunotherapy&#44; the gastric acid suppression and high doses of corticosteroids in the most severe cases&#46; Benefits of immunosuppressive treatment using infliximab have been shown in refractory cases&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interests&#46;</p></span></span>"
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                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Female&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Stage III&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stage IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cycles of nivolumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Previous immune-related adverse events&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">History of autoimmune disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Helicobacter pylori&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Previous treatment with immunotherapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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        0 => array:2 [
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            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gastritis inducida por nivolumab en un paciente con melanoma metast&#225;sico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Mart&#237;nez"
                            1 => "B&#46; Busto"
                            2 => "C&#46; Cerezo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rgmx.2020.07.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "Revista de Gastroenterolog&#237;a de M&#233;xico"
                        "fecha" => "2021"
                        "volumen" => "86"
                        "paginaInicial" => "90"
                        "paginaFinal" => "91"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33309401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nivolumab-induced concomitant severe upper and lower gastrointestinal immune-related adverse effects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Alhatem"
                            1 => "K&#46; Patel"
                            2 => "B&#46; Eriksen"
                            3 => "S&#46; Bukhari"
                            4 => "C&#46; Liu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.14309/crj.0000000000000249"
                      "Revista" => array:5 [
                        "tituloSerie" => "ACG Case Rep J"
                        "fecha" => "2019"
                        "volumen" => "6"
                        "paginaInicial" => "e00249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32309466"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endoscopic evaluation of immunotherapy-induced gastrointestinal toxicity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I&#46; Iranzo"
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                            2 => "P&#46; Su&#225;rez"
                            3 => "L&#46; Ferrer-Barcel&#243;"
                            4 => "V&#46; Iranzo"
                            5 => "J&#46; Sempere"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4253/wjge.v10.i12.392"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Gastrointest Endosc"
                        "fecha" => "2018"
                        "volumen" => "10"
                        "paginaInicial" => "392"
                        "paginaFinal" => "399"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30631403"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "4"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics and outcomes of gastritis associated with immune checkpoint inhibitors&#58; scoping review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Obeidat"
                            1 => "K&#46; Silangcruz"
                            2 => "L&#46; Kozai"
                            3 => "E&#46; Wien"
                            4 => "Y&#46; Fujiwara"
                            5 => "Y&#46; Nishimura"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CJI.0000000000000435"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Immunother"
                        "fecha" => "2022"
                        "volumen" => "45"
                        "paginaInicial" => "363"
                        "paginaFinal" => "369"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35972801"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "5"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Severe steroid refractory gastritis induced by Nivolumab&#58; a case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Vindum"
                            1 => "J&#46; Agnholt"
                            2 => "A&#46; Nielsen"
                            3 => "M&#46;B&#46; Nielsen"
                            4 => "H&#46; Schmidt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3748/wjg.v26.i16.1971"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Gastroenterol"
                        "fecha" => "2020"
                        "volumen" => "26"
                        "paginaInicial" => "1971"
                        "paginaFinal" => "1978"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32390707"
                            "web" => "Medline"
                          ]
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Article information
ISSN: 24443824
Original language: English
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