Treatment of Celiac Disease with Diarrhoea in Patients Receiving Immune Checkpoint Inhibitors

Clinical Scenario

Diarrhoea & ICI Therapy

Coeliac disease confirmed in a patient currently receiving immune checkpoint inhibitors (ICI), presenting with diarrhoea or a CeD-like enteropathy. When diarrhoea develops in this setting, coeliac serology should be obtained. Once CeD is confirmed, first-line management is a strict gluten-free diet (GFD).

Treatment Approach

Presentations that are severe or that do not respond adequately to a gluten-free diet may require a systemic immunosuppressive approach — the specific pathway and criteria depend on the full protocol.

The complete regimen, decision criteria, and multidisciplinary considerations are available in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1002/ueg2.70195

In patients receiving immune checkpoint inhibitors (ICI) who develop diarrhoea, coeliac serology should be obtained.
First‑line management is a strict GFD when CeD is confirmed.
Systemic immunosuppression or modification of immunotherapy should be reserved for severe presentations or cases not responding to a GFD, with decisions guided by multidisciplinary discussion.

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