Small‐Bowel Capsule Endoscopy in Immune‐Mediated Enterocolitis: A Case Series of Four Patients

ABSTRACT Immune checkpoint inhibitors (ICIs) have emerged as a cornerstone of cancer immunotherapy but are associated with immune‐mediated adverse events (imAEs), including gastrointestinal toxicities. Among these, enteritis is a less common but clinically significant complication. However, small in...

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Main Authors: Masayuki Orikasa, Tomoyoshi Shibuya, Hirotaka Ishino, Masashi Omori, Rina Odakura, Masao Koma, Kentaro Ito, Takafumi Maruyama, Kei Nomura, Dai Ishikawa, Mariko Hojo, Akihito Nagahara
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:JGH Open
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Online Access:https://doi.org/10.1002/jgh3.70201
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author Masayuki Orikasa
Tomoyoshi Shibuya
Hirotaka Ishino
Masashi Omori
Rina Odakura
Masao Koma
Kentaro Ito
Takafumi Maruyama
Kei Nomura
Dai Ishikawa
Mariko Hojo
Akihito Nagahara
author_facet Masayuki Orikasa
Tomoyoshi Shibuya
Hirotaka Ishino
Masashi Omori
Rina Odakura
Masao Koma
Kentaro Ito
Takafumi Maruyama
Kei Nomura
Dai Ishikawa
Mariko Hojo
Akihito Nagahara
author_sort Masayuki Orikasa
collection DOAJ
description ABSTRACT Immune checkpoint inhibitors (ICIs) have emerged as a cornerstone of cancer immunotherapy but are associated with immune‐mediated adverse events (imAEs), including gastrointestinal toxicities. Among these, enteritis is a less common but clinically significant complication. However, small intestinal involvement remains under‐recognized, and endoscopic findings are not well characterized. We report four cases of imAE enteritis in which small‐bowel capsule endoscopy (SBCE) was performed. SBCE revealed variable mucosal abnormalities, including villous atrophy, aphthous ulcers, and extensive erosions; in one case, deep circumferential ulcers with stricture were observed. While one patient responded to corticosteroids, the other three required escalation to biologic therapy due to steroid‐refractory disease. These findings suggest that SBCE may play a valuable role in assessing disease extent and predicting treatment responsiveness in imAE enteritis. Early utilization of SBCE could facilitate timely therapeutic decision‐making in affected patients.
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institution Kabale University
issn 2397-9070
language English
publishDate 2025-06-01
publisher Wiley
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series JGH Open
spelling doaj-art-882990b398624d61a99a36296ba734b22025-08-20T03:30:25ZengWileyJGH Open2397-90702025-06-0196n/an/a10.1002/jgh3.70201Small‐Bowel Capsule Endoscopy in Immune‐Mediated Enterocolitis: A Case Series of Four PatientsMasayuki Orikasa0Tomoyoshi Shibuya1Hirotaka Ishino2Masashi Omori3Rina Odakura4Masao Koma5Kentaro Ito6Takafumi Maruyama7Kei Nomura8Dai Ishikawa9Mariko Hojo10Akihito Nagahara11Department of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanABSTRACT Immune checkpoint inhibitors (ICIs) have emerged as a cornerstone of cancer immunotherapy but are associated with immune‐mediated adverse events (imAEs), including gastrointestinal toxicities. Among these, enteritis is a less common but clinically significant complication. However, small intestinal involvement remains under‐recognized, and endoscopic findings are not well characterized. We report four cases of imAE enteritis in which small‐bowel capsule endoscopy (SBCE) was performed. SBCE revealed variable mucosal abnormalities, including villous atrophy, aphthous ulcers, and extensive erosions; in one case, deep circumferential ulcers with stricture were observed. While one patient responded to corticosteroids, the other three required escalation to biologic therapy due to steroid‐refractory disease. These findings suggest that SBCE may play a valuable role in assessing disease extent and predicting treatment responsiveness in imAE enteritis. Early utilization of SBCE could facilitate timely therapeutic decision‐making in affected patients.https://doi.org/10.1002/jgh3.70201enterocolitisimmune‐mediated adverse eventsimmune‐related adverse eventssmall bowel endoscopy findings
spellingShingle Masayuki Orikasa
Tomoyoshi Shibuya
Hirotaka Ishino
Masashi Omori
Rina Odakura
Masao Koma
Kentaro Ito
Takafumi Maruyama
Kei Nomura
Dai Ishikawa
Mariko Hojo
Akihito Nagahara
Small‐Bowel Capsule Endoscopy in Immune‐Mediated Enterocolitis: A Case Series of Four Patients
JGH Open
enterocolitis
immune‐mediated adverse events
immune‐related adverse events
small bowel endoscopy findings
title Small‐Bowel Capsule Endoscopy in Immune‐Mediated Enterocolitis: A Case Series of Four Patients
title_full Small‐Bowel Capsule Endoscopy in Immune‐Mediated Enterocolitis: A Case Series of Four Patients
title_fullStr Small‐Bowel Capsule Endoscopy in Immune‐Mediated Enterocolitis: A Case Series of Four Patients
title_full_unstemmed Small‐Bowel Capsule Endoscopy in Immune‐Mediated Enterocolitis: A Case Series of Four Patients
title_short Small‐Bowel Capsule Endoscopy in Immune‐Mediated Enterocolitis: A Case Series of Four Patients
title_sort small bowel capsule endoscopy in immune mediated enterocolitis a case series of four patients
topic enterocolitis
immune‐mediated adverse events
immune‐related adverse events
small bowel endoscopy findings
url https://doi.org/10.1002/jgh3.70201
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