case_images: PMC8718638_01
case_images: Endoscopic findings (A, B) and duodenal biopsies (C, D) after 2 cycles of nivolumab. (A, B) Major duodenitis associated with diffuse superficial ulcerations. (C, D) Histological examination revealed elementary lesions: increased intraepithelial T lymphocytes (IEL) (>30 IEL/100 enterocytes), crypt hyperplasia, and villous atrophy with alteration of normal crypt/villous ratio (3:1).
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case_images: Esophago-gastroduodenoscopy (EGD) showed a major duodenitis with erythematous aspect and diffuse superficial ulcerations ( Figures 1A, B ). T lymphocytes (IEL) (>30 IEL/100 enterocytes), crypt hyperplasia, marked villous atrophy, and alteration of normal crypt/villous ratio (3:1) ( Figures 1C, D ). The CeD was graded type 3b according to the modified Marsh classification of histologic findings in CeD (Oberhuber).
case_images: Endoscopic findings (A, B) after 2 months of gluten-free disease. Complete healing of the inflammatory aspect and of the ulcerations of the duodenum.
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case_images: A control EGD was realized, finding a complete healing of the inflammatory aspect and of the ulcerations of the duodenum ( Figure 2 ).
case_images: Timeline of the case report.
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case_images: f3