Journal of

Case Reports and Images in Medicine

 
   
Case Report
 
Ipilimumab-nivolumab combination therapy leads to biopsy proven immune-mediated pancreatitis
Joshua B. French1, Eizaburo Sasatomi2, Lisa M Gangarosa1
1MD, Department of Medicine: Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
2MD, PhD, Department of Pathology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States

Article ID: 100041Z09JF2017
doi: 10.5348/Z09-2017-41-CR-13

Address correspondence to:
Lisa M. Gangarosa
MD, University of North Carolina at Chapel Hill
130 Mason Farm Road CB# 7080
Chapel Hill
NC 27599

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How to cite this article
French JB, Sasatomi E, Gangarosa LM. Ipilimumab-nivolumab combination therapy leads to biopsy proven immune-mediated pancreatitis. J Case Rep Images Med 2017;3:46–49.

Abstract


Introduction: Oncologic therapies are continuing to expand and include classes of medications whose primary mechanism of action results in targeted immunotherapy. As with any new therapy, these medications have side effects. In particular, nivolumab and ipilimumab have been associated with side effects involving the gastrointestinal tract, including asymptomatic elevations in pancreatic enzymes as well as rare cases of overt acute pancreatitis.
Case Report: We present a case of combination nivolumab and ipilimumab induced acute pancreatitis during which an endoscopic ultrasound guided fine needle biopsy was obtained. The biopsy demonstrated a T cell rich inflammatory infiltrate, consistent with an immune-mediated acute pancreatitis. This is the first report to include histologic findings.
Conclusion: Checkpoint inhibitors can cause acute pancreatitis via an immune mediated mechanism with lymphocytic infiltration.

Keywords: Checkpoint inhibitors, Ipilimumab, Nivolumab, Pancreatitis

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Author Contributions
Joshua B. French – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Eizaburo Sasatomi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Lisa M. Gangarosa – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Joshua B. French et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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