Immune Checkpoint Inhibitor-Mediated Colitis
Grade ...
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Description

Immune Checkpoint Inhibitor-Mediated Colitis

Grade of Disease Severity:

 • G1: Increase < 4 BMs/day over baseline; mild increase ostomy output over baseline

 • G2: Increase 4-6 BMs/day over baseline; mod increase ostomy output over baseline

 • G3: Increase > 7 BMs/day over baseline; severe increase ostomy output over baseline; incontinence; hospitalization; limiting self-care ADL

 • G4: Life-threatening consequences; urgent intervention indicated

Diagnostic Evaluation: G2-4

 • Consult GI

 • Labs: CBC, CMP, TSH, ESR, CRP

 • Stool: C. Diff, Stool cx, O&P, GPP, etc.

 • Endoscopy (Flex Sig or Colon +EGD):

     - Random Bx and IHC staining r/oCMV

     - G2: consider early in course to prognosticate

     - G3/4: urgent

 • Imaging: Cross-sectional Imaging (MR/CT) if c/f complication

 • Consider: HAV/HBV serologies, HIV screen, IGRAs, fecal calprotectin or lactoferrin



Dr. Waseem Ahmed @Waseem_AhmedMD



#Immune #CheckpointInhibitor #Colitis #diagnosis #management #algorithm #IBD
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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