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Here we present a case with widespread metastatic melanoma who developed rapid onset anasarca and transaminitis after initiating combination nivolumab/ipilimumab (PD-1/CTLA-4 inhibition). An extensive work-up included serologies returning positive for TTG IgA and endoscopy revealing duodenal mucosal atrophy with pathognomonic features confirming celiac disease. All symptoms resolved after initiation of a gluten-free diet without the addition of immunosuppression. The patient eventually passed away due to cancer progression.

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Celiac Disease in the Setting of Immune Checkpoint Inhibitor Therapy

  • 章节

  • 发表日期：

    2025年

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  • Ayo Falade,
  • Yousef Badran,
  • Michael Dougan

摘要

Here we present a case with widespread metastatic melanoma who developed rapid onset anasarca and transaminitis after initiating combination nivolumab/ipilimumab (PD-1/CTLA-4 inhibition). An extensive work-up included serologies returning positive for TTG IgA and endoscopy revealing duodenal mucosal atrophy with pathognomonic features confirming celiac disease. All symptoms resolved after initiation of a gluten-free diet without the addition of immunosuppression. The patient eventually passed away due to cancer progression.