International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: Editor-in-chief: Samasca Gabriel
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International Journal of Celiac Disease. 2020, 8(1), 28-31
DOI: 10.12691/ijcd-8-1-5
Open AccessArticle

Sprue-like Intestinal Disease Induced by Checkpoint Inhibitor Immunotherapy

Hugh J. Freeman1,

1Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada

Pub. Date: April 27, 2020

Cite this paper:
Hugh J. Freeman. Sprue-like Intestinal Disease Induced by Checkpoint Inhibitor Immunotherapy. International Journal of Celiac Disease. 2020; 8(1):28-31. doi: 10.12691/ijcd-8-1-5


In recent years, immune checkpoint inhibitors have been increasingly used in cancer treatment with significant improvements in overall survival. A downside of these agents has been the emergence of novel intestinal diseases as reflected by development of diarrhea, sometimes severe, in at least 10%. In some, an immune-mediated enterocolitis may often develop. This may be severe, difficult to manage and result in a fatal outcome. Less well appreciated, however, are other less commonly detected forms of colitis, such as collagenous colitis, along with small bowel changes, specifically, sprue-like intestinal disease, apparently occurring as an independent inflammatory process. Taken together, these are likely to represent different pathological phenotypic expressions of treatment toxicity in the intestinal tract following management of cancer with checkpoint inhibitors.

celiac disease sprue-like intestinal disease enteritis enterocolitis checkpoint inhibitors advanced malignancy metastatic melanoma

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