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一名接受纳武单抗加伊匹单抗联合治疗的晚期黑色素瘤患者出现严重脱髓鞘性神经病。

Severe Demyelinating Neuropathy in an Advanced Melanoma Patient Treated with Nivolumab plus Ipilimumab Combined Therapy.

作者信息

Kambayashi Yumi, Fujimura Taku, Kuroda Hiroshi, Otsuka Atsushi, Irie Hiroyuki, Aiba Setsuya

机构信息

Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.

出版信息

Case Rep Oncol. 2020 Apr 30;13(1):474-477. doi: 10.1159/000506976. eCollection 2020 Jan-Apr.

DOI:10.1159/000506976
PMID:32508619
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7250384/
Abstract

Immune checkpoint inhibitors (ICIs) significantly prolong survival in patients with metastatic melanoma but can lead to serious immune-related adverse events. In this report, we described a case of atypical neuropathy caused by nivolumab plus ipilimumab combination therapy before primary tumor resection. In our case, not only demyelinating neuropathy, but also muscle weakness and unilateral facial nerve palsy developed and manifested as severe and diverse symptoms. Moreover, unlike spontaneously developing demyelinating peripheral neuropathy, the present case suggested the therapeutic effects of high-dose methylprednisolone monotherapy for the treatment of ICIs-induced immune-related demyelinating peripheral neuropathy.

摘要

免疫检查点抑制剂（ICIs）可显著延长转移性黑色素瘤患者的生存期，但可能导致严重的免疫相关不良事件。在本报告中，我们描述了一例在原发性肿瘤切除术前接受纳武单抗加伊匹单抗联合治疗引起的非典型神经病变病例。在我们的病例中，不仅出现了脱髓鞘性神经病变，还出现了肌肉无力和单侧面神经麻痹，症状严重且多样。此外，与自发发生的脱髓鞘性周围神经病变不同，本病例提示大剂量甲泼尼龙单药治疗对ICIs诱导的免疫相关脱髓鞘性周围神经病变具有治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec8/7250384/544999428c3b/cro-0013-0474-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec8/7250384/544999428c3b/cro-0013-0474-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec8/7250384/544999428c3b/cro-0013-0474-g01.jpg

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