Immune Checkpoint Inhibitor-Induced Pancreatitis.
Carlos Fernandez Moro, Atsuko Kasajima, Suzane Ribeiro et al.
✦ AI-curated · Sources linked
Case in brief
A case report described five female patients who developed immune checkpoint inhibitor-induced pancreatitis (ICIPI) after receiving combination ICI therapy. Symptoms appeared between 182-580 days post-treatment, with peak serum lipase levels ranging from 4 to 41 (µkat/L). Imaging revealed features consistent with autoimmune pancreatitis in four cases. Treatment with steroids led to resolution of pancreatitis in three patients, while two developed pancreatic atrophy or exocrine insufficiency.
What made this case unusual
Histological examination revealed marked overlap with type 2 autoimmune pancreatitis, including duct-centric inflammatory changes, despite the absence of IgG4-positive plasma cells characteristic of type 1 autoimmune pancreatitis.
Diagnostic / clinical pearl
Clinicians should be aware of the histological overlap between immune checkpoint inhibitor-induced pancreatitis and autoimmune pancreatitis, which can complicate diagnosis and management.
Why it matters
Understanding the histopathological features of ICIPI is crucial for accurate diagnosis and appropriate treatment, particularly in patients receiving immune checkpoint inhibitors.