A middle-aged woman with common symptoms and a rare disease Patient is a 58-year-old female who presented with symptoms of nausea, vomiting, weakness, fatigue, and abdominal pain. These symptoms have persisted for one week, and she had sought care from multiple physicians, receiving outpatient treatments including intravenous fluids and antiemetic injections, but without improvement. Upon referral to our facility, the patient was admitted, underwent a comprehensive evaluation, and was scheduled for an endoscopy. During the endoscopy, the esophagus and stomach appeared normal, but the duodenum showed signs of inflammation and a velvety appearance. Biopsy samples were taken.rectosigmoidoscopy without preparation was normal.Given her medical history of uterine tumor treated with four courses of immunotherapy(Pembrolizumab is a type of targeted therapy drug called an immune checkpoint inhibitor), we suspected drug-induced enteropathy. Treatment with 100 mg of hydrocortisone was initiated, resulting in a dramatic response. After a course of treatment, the patient was discharged on an oral dose of 5 mg prednisolone, with good general condition. While awaiting the pathology results, the patient experienced a recurrence of her previous symptoms and was readmitted.The pathology results indicated CMV enteritis, although it was not confirmed by IHC and PCR stool tests. As a result, we discharged the patient in stable condition with a high dose of Prednisone at 50 mg daily and referred her to an oncologist for further evaluation.

A middle-aged woman with common symptoms and a rare disease Patient is a 58-year-old female who presented with symptoms of nausea, vomiting, weakness, fatigue, and abdominal pain. These symptoms have persisted for one week, and she had sought care from multiple physicians, receiving outpatient treatments including intravenous fluids and antiemetic injections, but without improvement. Upon referral to our facility, the patient was admitted, underwent a comprehensive evaluation, and was scheduled for an endoscopy. During the endoscopy, the esophagus and stomach appeared normal, but the duodenum showed signs of inflammation and a velvety appearance. Biopsy samples were taken.rectosigmoidoscopy without preparation was normal.Given her medical history of uterine tumor treated with four courses of immunotherapy(Pembrolizumab is a type of targeted therapy drug called an immune checkpoint inhibitor), we suspected drug-induced enteropathy. Treatment with 100 mg of hydrocortisone was initiated, resulting in a dramatic response. After a course of treatment, the patient was discharged on an oral dose of 5 mg prednisolone, with good general condition. While awaiting the pathology results, the patient experienced a recurrence of her previous symptoms and was readmitted.The pathology results indicated CMV enteritis, although it was not confirmed by IHC and PCR stool tests. As a result, we discharged the patient in stable condition with a high dose of Prednisone at 50 mg daily and referred her to an oncologist for further evaluation.

Check point induced enteropathy