title: Infectious Colitis Associated With Ipilimumab Therapy.
abstract: Ipilimumab is a monoclonal antibody against cytotoxic T lymphocyte-associated molecule-4 and is thought to promote anti-tumor activity by enhancing cell mediated immunity. It is one of the few therapies shown to improve overall survival in metastatic melanoma. Given its mechanism of action, the drug is associated with significant immune-related adverse events with the gastrointestinal system being commonly involved. Our patient is a 22-year-old female with stage IVA melanoma on ipilimumab therapy who presented with fever, diarrhea and abdominal pain. She gave a history of recent travel to a wedding where several other guests in attendance had also developed diarrheal illnesses. Her colonoscopy and pathology were consistent with ipilimumab-induced colitis. Her stool culture returned positive forSalmonella enteritides.She was treated with prednisone and ciprofloxacin with resolution of her symptoms. In our case, we describe ipilimumab-induced colitis where an infectious pathogen was identified with temporal relationship to symptoms and could be suggestive of a causal relationship.
authors: Vanderbilt University Hospital, Department of Medicine, 1161 21st Ave South, D3100 Medical Center North, Nashville, TN 37232, USA.
authors: Jessica L
authors: JL
authors: McCutcheon
authors: Vanderbilt University Hospital, Department of Pathology, Microbiology, and Immunology, 1161 21st Avenue South, CC 3322 Medical Center North, Nashville TN 37232, USA.
authors: Colt M
authors: CM
authors: McClain
authors: Vanderbilt University Hospital, Hematology/Oncology Division, 777 Preston Research building Nashville, TN 32232, USA.
authors: Igor
authors: I
authors: Puzanov
authors: Vanderbilt University Hospital, Division of Gastroenterology, Hepatology, and Nutrition, 1301 Medical Center Drive, 1160 The Vanderbilt Clinic, Nashville, TN 37232, USA.
authors: Terrence A
authors: TA
authors: Smith
keywords: Colitis; Infectious diarrhea; Ipilimumab