Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8829001 | Progrès en Urologie - FMC | 2018 | 4 Pages |
Abstract
Digestive toxicity is common for 15Â % of patients on immunotherapy, and often observed in the first 3Â months. To prevent it, patients and caregivers should be informed, looking for: risk factors, a history of autoimmune diseases, and new symptoms or worsening of existing symptoms. Diarrhea should be monitored (dehydration, hypokalemia). Rehydration and loperamide for grades 1-2Â will suffice, but at grade 3Â treatment by immunotherapy should be suspended, loperamide stopped, and corticosteroid therapy started. Stool culture (Clostridium difficile) should be performed at grade 3. Toxicity should be confirmed by sigmoidoscopy. One to 5Â % of cases will result in perforated inflammatory colitis and there is 1Â % of deaths related to digestive complications. Liver assessment should be done before each treatment to eliminate cytolysis. The incidence of hepatotoxicity of immunotherapy is 5Â to 10Â %, and at grade 2Â immunotherapy should be stopped and corticosteroid therapy started.
Related Topics
Health Sciences
Medicine and Dentistry
Urology
Authors
P. Léon, S. Champiat, F. Carbonnel,