Severe cytomegalovirus gastritis and hypogammaglobulinemia in a patient treated with pembrolizumab.

Eur J Gastroenterol HepatolJun 3, 2026 (epub)
Case ReportGastroenterologyOncology (Medical)

Federico Sottotetti, Giovanni Arpa, Lucrezia Spina et al.

✦ AI-curated · Sources linked

Case in brief

A 66-year-old man with stage IVB oesophageal carcinoma, treated with pembrolizumab, presented with gastric erosions and ulcers. Biopsies revealed lymphoplasmacytic and neutrophilic infiltrates, indicating immune checkpoint inhibitor-induced gastritis. Following transient relief with high-dose steroids, cytomegalovirus (CMV) DNA was detected in gastric biopsies. After steroid withdrawal and treatment with intravenous ganciclovir, the patient showed partial improvement, but developed haemorrhagic gastritis due to hypogammaglobulinemia, which resolved rapidly with intravenous immunoglobulins.

Diagnostic / clinical pearl

Clinicians should consider tissue-based CMV testing in patients with severe gastritis, especially those on immunotherapy, and be cautious with steroid use.

Why it matters

This case highlights the potential for severe immunodeficiency in patients receiving immune checkpoint inhibitors, necessitating careful monitoring and management.

Source

PubMed · PMID 42467928

Published in Eur J Gastroenterol Hepatol. 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 It is not peer reviewed and is not a substitute for the original article.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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AI-generated summaries may contain errors or omissions. Verify clinically important information with the original publication.

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