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Colitis due to idelalisib in a patient with follicular lymphoma
Colitis por idelalisib en un paciente con linfoma folicular
Marta Canelo-Vilaseca
, Josep-Maria Ribera Santasusana, Juan-Manuel Sancho Cia
Corresponding author
Servicio de Hematología, Institut Català d’Oncologia-Institut de Recerca Josep Carreras-Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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The results of the stool culture and polymerase chain reaction for cytomegalovirus (CMV) in peripheral blood were negative. Due to suspected gastrointestinal toxicity, idelalisib was discontinued and budesonide was started, with clinical resolution after two weeks. Idelalisib was restarted (dose of 100 mg/12 h) and budesonide was maintained, but after seven weeks the patient experienced a recurrence of the symptoms. Positron emission tomography combined with computed tomography (PET/CT) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) showed increased diffuse metabolic uptake of the descending colon and rectum compatible with colitis, as well as partial response of the lymphoma. Colonoscopy ruled out CMV infection. Idelalisib was definitively discontinued, and oral prednisone was added with clinical and radiological resolution after four weeks (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Gastrointestinal toxicity associated with idelalisib (PI3K inhibitor™ approved in FL refractory to two lines of treatment) is common. It is important to distinguish its aetiology (CMV or immune-mediated infection) with a view to correct treatment.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-01-16" "fechaAceptado" => "2022-01-19" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Canelo-Vilaseca M, Ribera Santasusana J-M, Sancho Cia J-M. Colitis por idelalisib en un paciente con linfoma folicular. Med Clin (Barc). 2022;159:106.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1036 "Ancho" => 1508 "Tamanyo" => 96320 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">PET/CT with increased diffuse metabolic uptake of the descending colon and sigmoid colon compatible with colitis.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1023 "Ancho" => 1508 "Tamanyo" => 96676 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">PET/CT showing increased metabolic uptake returning to normal.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015900000002/v1_202207200641/S2387020622003096/v1_202207200641/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015900000002/v1_202207200641/S2387020622003096/v1_202207200641/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622003096?idApp=UINPBA00004N" ]
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