由纳武单抗诱导的脑病伴Hu自身抗体导致的复发性言语困难。
Recurrent dysphasia due to nivolumab-induced encephalopathy with presence of Hu autoantibody.
作者信息
Raskin Jo, Masrori Pegah, Cant Antonin, Snoeckx Annemie, Hiddinga Birgitta, Kohl Sisca, Janssens Annelies, Cras Patrick, Van Meerbeeck Jan P
机构信息
Department of Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium.
Department of Neurology, Antwerp University Hospital, Edegem, Belgium.
出版信息
Lung Cancer. 2017 Jul;109:74-77. doi: 10.1016/j.lungcan.2017.05.002. Epub 2017 May 10.
A 58-year-old man was being treated for squamous non-small-cell lung cancer with nivolumab. At the 17th of biweekly administrations he presented with global dysphasia, dysarthria and myoclonus in the right upper extremity. MRI showed multiple T2/FLAIR hyperintense lesions in the left hemisphere; lumbar puncture showed lymphocytic pleiocytosis in the CSF without identifiable pathogens. Hu antibodies were present in serum and CSF. Nivolumab was discontinued and corticosteroids were administered. The neurological symptoms gradually improved; MRI showed complete remission of cerebral lesions. After rechallenge with nivolumab his symptoms and cerebral lesions recurred, proving the causal relationship with nivolumab. After tapering of corticosteroids, a second relapse occurred.
一名58岁男性正在接受纳武单抗治疗鳞状非小细胞肺癌。在第17次双周给药时，他出现了全面性失语、构音障碍和右上肢肌阵挛。磁共振成像（MRI）显示左半球有多个T2/液体衰减反转恢复序列（FLAIR）高信号病变；腰椎穿刺显示脑脊液中有淋巴细胞增多，但未发现可识别的病原体。血清和脑脊液中存在Hu抗体。停用纳武单抗并给予皮质类固醇。神经症状逐渐改善；MRI显示脑部病变完全缓解。再次使用纳武单抗后，他的症状和脑部病变复发，证实了与纳武单抗的因果关系。在逐渐减少皮质类固醇用量后，再次复发。
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