An Indolent Enteropathy Accelerated by Combination Immune Checkpoint Inhibitor Therapy

The emergence of immunotherapy has dramatically altered the landscape of cancer treatment, leading to improved clinical outcomes for several malignancies. However, gastrointestinal immune-related adverse events are commonly encountered, and among patients with underlying autoimmune disorders, the risks and sequelae of such events may be more significant. Here, we present the case of a 76-year-old woman who developed isolated enteritis with diffuse ulceration shortly after the initiation of ipilimumab and nivolumab and ultimately passed away from refractory gastrointestinal bleeding. The clinical, endoscopic, and histologic findings were suggestive of a preexisting enteropathy that was rapidly accelerated by immune checkpoint inhibitor exposure.