Immune checkpoint inhibitors have revolutionized cancer therapy. Immune-related adverse events affect multiple organ systems, most commonly the gastrointestinal tract. Early recognition and management are essential to prevent morbidity and mortality. We report a patient with diarrhea initially managed as immune-related colitis. Recrudescent symptoms prompted further endoscopic work-up demonstrating celiac disease and microscopic colitis. We encourage clinicians to have high clinical suspicion for causes other than immune-related colitis for patients presenting with diarrhea in the setting of immunotherapy. We propose early involvement of the gastroenterology service for endoscopic evaluation and biopsy for appropriate diagnosis and management.
Mandava et al. (Mon,) studied this question.
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