Okayama Igakkai Zasshi (Journal of Okayama Medical Association)
Online ISSN : 1882-4528
Print ISSN : 0030-1558
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The 2023 Okayama Medical Association Awards
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Case Report
  • A case of immune checkpoint inhibitor-associated colitis treated with infliximab
    Masaya Iwamuro, Sakiko Hiraoka, Motoyuki Otsuka
    2024 Volume 136 Issue 2 Pages 69-73
    Published: August 01, 2024
    Released on J-STAGE: September 02, 2024
    DOIhttps://doi.org/10.4044/joma.136.69
    JOURNAL RESTRICTED ACCESS
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    　A 52-year-old Japanese man diagnosed with non-small cell lung cancer initiated chemotherapy with tremelimumab, durvalumab, nanoparticle albumin-bound paclitaxel, and carboplatin. On the fourth day of the first treatment course, he developed a fever, followed by watery diarrhea exceeding 10 episodes per day and bloody stools the next day. Immunotherapy-related adverse event colitis was diagnosed through CT scans and colonoscopy examinations. Despite the ineffectiveness of systemic steroid administration, prompt alleviation of symptoms was achieved through the administration of infliximab. In our case, the patient developed Grade 3 diarrhea, prompting the initiation of intravenous prednisolone at 80mg/day in accordance with guidelines. However, symptom improvement was not attained. In situations where symptoms persist beyond three days despite systemic steroid administration, the consideration of adjunctive infliximab use at a dosage of 5mg/kg becomes necessary.
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