Low-dose methylprednisolone treatment for immune-associated colitis induced by sintilimab
10.3760/cma.j.cn114015-20240402-00220
- VernacularTitle:低剂量甲泼尼龙治疗信迪利单抗诱发的免疫相关性结肠炎
- Author:
Wenjun TANG
1
;
Qixing YAN
Author Information
1. 海南医学院第二附属医院肿瘤内科，海口 570311
- Publication Type:Journal Article
- Keywords:
Antineoplastic agents, immunological;
Colitis;
Drug toxicity;
Sintilimab;
Methylprednisolone
- From:
Adverse Drug Reactions Journal
2025;27(1):59-61
- CountryChina
- Language:Chinese
-
Abstract:
A 66-year-old male patient with esophageal cancer progressed after concurrent radiotherapy and chemoradiotherapy, and received immunotherapy combined with chemotherapy (intravenous infusion of sintilimab 200 mg on day 1, tegafur gimeracil oteracil potassium 50 mg orally twice daily from day 1 to 14), with 21 days as a cycle. After 13 days of treatments, diarrhea appeared, and gradually worsened with abdominal pain and a small amount of mucous bloody stools. Colonoscopy showed diffuse swelling and punctiform hemorrhagic erosion of the mucosa of the colon and rectum. Histopathological examination of the ascending colon and sigmoid colon showed regular arrangement of glands, infiltration of lymphocytes, neutrophils and eosinophils in the interstitium, and formation of crypt abscesses, which were considered to be immune-associated colitis caused by sintilimab. After discontinuing the use of sintilimab and administering low-dose methylprednisolone (24 mg orally twice daily) for 3 days, the patient′s symptoms were completely relieved. The dose of methylprednisolone was reduced gradually and discontinued within 4 weeks. The patient did not rechallenge immune checkpoint inhibitors and continued maintenance therapy with tegafur gimeracil oteracil potassium, and no diarrhea recurred
