TY - JOUR T1 - Anorexia, vomiting and weight loss in a 22-year-old woman JF - Gut JO - Gut SP - 803 LP - 927 DO - 10.1136/gutjnl-2018-317023 VL - 68 IS - 5 AU - Vincent Ting Fung Cheung AU - Eve Fryer AU - Miranda J Payne AU - Oliver Brain Y1 - 2019/05/01 UR - http://gut.bmj.com/content/68/5/803.abstract N2 - A 22-year-old woman presented in December 2017 with a 2-month history of postprandial abdominal pain, nausea, vomiting, early satiety and 4 kg weight loss. She had entirely normal bowel habit. She did not use non-steroidal anti-inflammatory drugs and omeprazole had not helped her symptoms. Her medical history included resection of 1.8 mm Spitz melanoma in June 2010 and left axillary dissection in November 2012 (3/22 nodes positive). She received first-line ipilimumab and nivolumab starting November 2016. Cycle 2 was complicated by grade 2 hepatotoxicity that resolved spontaneously; cycle 4 by grade 3 hepatotoxicity requiring steroids and mycophenolate mofetil (discontinued in August 2017). She had stereotactic radiosurgery for a right temporal lobe metastasis in June 2017 and restarted on maintenance nivolumab monotherapy in July 2017. In December … ER -