title: Ipilimumab and immune-mediated adverse events: a case report of anti-CTLA4 induced ileitis.
abstract: BACKGROUND
  Ipilimumab is a fully human monoclonal antibody directed against cytotoxic T-lymphocyte antigen-4 , a key negative regulator of T-cell activation approved by the Food and Drug Administration as of March 2011 for the treatment of metastatic melanoma. As a result of the up-regulation of the immune system, several immune-mediated adverse effects have been reported including colitis, dermatitis, hepatitis and rarely hypophysitis. The most frequent immune-mediated adverse effects described in literature include gastrointestinal toxicity such as diarrhea, colitis and case of colitis and ileitis.
  
  
  METHODS
  In this paper we report an interesting case of immune-mediate ileitis without colitis in a 54 years old woman with metastatic melanoma treated with ipilimumab. We also discuss about case management and the possible pathological mechanisms considering also previous reports.
  
  
  CONCLUSIONS
  The aim of this article is to support further investigations concerning epigenetic and genetic analysis in order to personalize biological therapy and to reduce immune related adverse events observed after ipilimumab administration.
authors.affiliation: Department of Medical Oncology, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 200, 00128, Rome, Italy. o.venditti@unicampus.it.
authors.forename: Olga
authors.initials: O
authors.lastname: Venditti
authors.affiliation: Department of Medical Oncology, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 200, 00128, Rome, Italy. d.delisi@unicampus.it.
authors.forename: Delia
authors.initials: D
authors.lastname: De Lisi
authors.affiliation: Department of General Surgery, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 200, 00128, Rome, Italy. m.caricato@unicampus.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Caricato
authors.affiliation: Department of General Surgery, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 200, 00128, Rome, Italy. d.caputo@unicampus.it.
authors.forename: Damiano
authors.initials: D
authors.lastname: Caputo
authors.affiliation: Department of General Surgery, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 200, 00128, Rome, Italy. g.capolupo@unicampus.it.
authors.forename: Gabriella Teresa
authors.initials: GT
authors.lastname: Capolupo
authors.affiliation: Department of Pathology Università, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 200, 00128, Rome, Italy. c.taffon@unicampus.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Taffon
authors.affiliation: Department of Radiology Università, Campus Bio-Medico di Roma, Via Álvaro del Portillo, 200, 00128, Rome, Italy. e.pagliara@unicampus.it.
authors.forename: Elisa
authors.initials: E
authors.lastname: Pagliara
authors.affiliation: Department of Radiology Università, Campus Bio-Medico di Roma, Via Álvaro del Portillo, 200, 00128, Rome, Italy. s.battisti@unicampus.it.
authors.forename: Sofia
authors.initials: S
authors.lastname: Battisi
authors.affiliation: Department of Medical Oncology, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 200, 00128, Rome, Italy. a.frezza@unicampus.it.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Frezza
authors.affiliation: Department of Pathology Università, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 200, 00128, Rome, Italy. a.onetti@unicampus.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Onetti Muda
authors.affiliation: Department of Medical Oncology, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 200, 00128, Rome, Italy. g.tonini@unicampus.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tonini
authors.affiliation: Department of Medical Oncology, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 200, 00128, Rome, Italy. d.santini@unicampus.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007079:Ileitis / Q000139:chemically induced* / Q000473:pathology*; D000074324:Ipilimumab; D008545:Melanoma / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D057285:Precision Medicine; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D000074324:Ipilimumab