Pembrolizumab-induced duodenitis mimicking celiac disease

Authors

Yannis Lafazanos, Advocate Health - MidwestFollow
Robin David, Advocate Health - MidwestFollow
Nahren Asado, Advocate Health - MidwestFollow
Miguel Gonzalez, Advocate Health - MidwestFollow
Eli D. Ehrenpreis, Advocate Health - MidwestFollow

Recommended Citation

Lafazanos Y, David R, Asado N, Gonzalez M, Ehrenpreis ED. Pembrolizumab-Induced Duodenitis Mimicking Celiac Disease. ACG Case Rep J. 2025;12(7):e01756. Published 2025 Jul 21. doi:10.14309/crj.0000000000001756

Affiliations

Advocate Lutheran General Hospital

Abstract

Pembrolizumab is a programmed cell death-1 (PD-1) inhibitor frequently used as primary immunotherapy in many cancers, including melanoma, lung, renal cell, cervical, urothelial, and gastric cancers. Given its immune-checkpoint inhibition and upregulation of the immune response, pembrolizumab has been associated with many immune system-related adverse effects including stomatitis, conjunctivitis, pneumonitis, myositis, and even type 1 diabetes mellitus. Colitis is the most frequent gastrointestinal adverse reaction, with upper gastrointestinal reactions like esophagitis, gastritis, and duodenitis being rare. In this report, we present a case of pembrolizumab-induced enteropathy that endoscopically and histologically mimicked celiac disease.

Type

Article

PubMed ID

40692728