Enhancer of Zeste Homolog 1 and 2 Inhibitor-induced Colitis Mimicking Immune Checkpoint Inhibitor-induced Colitis.

Intern MedMar 17, 2026 (epub)
Case ReportOncology (Medical)GastroenterologyPathology (Anatomic & Clinical)

Keisuke Iwata, Kenji Yamazaki, Ryoji Kushima et al.

✦ AI-curated · Sources linked

Case in brief

An 80-year-old woman with relapsed nodal T-follicular helper cell lymphoma developed severe watery diarrhea while receiving valemetostat, an EZH1/2 inhibitor. Colonoscopy showed diffuse mucosal erythema and edema. Biopsy demonstrated lymphoplasmacytic infiltration, crypt abscesses, and apoptotic bodies, with CD3-positive T cells predominating and abundant CD8-positive cells. The findings resembled immune checkpoint inhibitor-induced colitis. Her diarrhea improved after valemetostat was discontinued, without additional treatment.

What made this case unusual

The colitis associated with EZH1/2 inhibitor therapy mimicked immune checkpoint inhibitor-induced colitis clinically and histologically, raising a diagnostic consideration beyond the drug class more commonly linked to this pattern.

Diagnostic / clinical pearl

In a patient receiving an EZH1/2 inhibitor who develops persistent diarrhea, consider drug-associated colitis; endoscopic and histological assessment can help characterize the injury.

Source

PubMed · PMID 41850836

Published in Intern Med. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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