Acute neutrophilic gastritis induced by nivolumab used as a treatment of non- metastatic malignant melanoma

Severe Gastritis Due to Nivolumab Treatment of a Metastatic Melanoma Patient

“…On the contrary, in the present case, symptoms from the upper GI tract occurred 6 months after the initiation of nivolumab treatment, a finding similar to those reported by Boike et al and Kobayashi et al, describing upper GI disorders six and four months after the initiation of treatment, respectively [ 5 , 7 ]. The present case’s histological findings are particular, since mostly eosinophiles have infiltrated the mucosa and the surface of the epithelium, while in previous cases the infiltration was also characterized by eosinophiles, but mainly by neutrophiles and CD4, CD8 and CD20 lymphocytes [ 5 , 7 , 12 , 13 , 14 ].…”

“…There was an inflammatory infiltration of the lamina propria with an increased number of eosinophiles, while eosinophiles were also extended into the surface of the epithelium. It is of note that other investigators have observed similar histological inflammatory findings induced by nivolumab and other ICPis with infiltration of the gastric mucosa by eosinophiles and also by neutrophils and/or by CD4, CD8 and CD20 lymphocytes [ 12 , 14 ].…”

“…In particular, there is a very limited number of nivolumab-associated upper GI tract toxicities reported in the English literature. Boike et al reported esophagitis and gastritis after nivolumab treatment for malignant lymphoma, Kobayashi et al hemorrhagic gastritis after nivolumab treatment for non-small cell lung cancer, Nguyin Tran et al nivolumab-associated upper GI injury, Ojega Gomez et al nivolumab induced neutrophilic gastritis, while Vindum et al severe steroid refractory nivolumab induced gastritis, finally treated with infliximab [ 5 , 7 , 9 , 12 , 13 ].…”

Severe gastritis in a patient treated with immunotherapy: immune-mediated or reactivation of cytomegalovirus?

“…CMV gastritis may occur in these patients by reactivation or primoinfection. Mucosal inflammation, immunotherapy-induced dysregulation of the immune system and corticosteroid-related immunosuppression are the main mechanisms of reactivation of latent CMV in the gastric mucosa (3).…”