Hou Yanli, Su Qiang, Tang Simeng, Li Hongyang
Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Brain Sci. 2022 Sep 14;12(9):1242. doi: 10.3390/brainsci12091242.
Anti-tumor immunotherapy with immune checkpoint inhibitors induces several immune-related adverse events. Camrelizumab-related isolate abducens neuritis is rare.
We report on a 67-year-old man with esophageal cancer who presented with acute-onset isolated right abducens cranial nerve palsy after ten cycles of Camrelizumab treatment. Magnetic resonance imaging examination revealed thickening and post-contrast enhancement at the cisternal segment of the right abducens nerve. The diagnosis was immune-related abducens neuritis caused by Camrelizumab. We put him on oral taper corticoids (methylprednisone) for neuritis treatment without Camrelizumab suspension. One month after treatment, he recovered completely. At the last follow-up, one year after the onset of diplopia, the patient was in good condition without neurological symptom recurrence.
Abducens neuritis is a rare immune-related adverse outcome of Camrelizumab. The present case proves the efficacy and safety of using corticoids in the treatment of abducens neuritis.
使用免疫检查点抑制剂进行抗肿瘤免疫治疗会引发多种免疫相关不良事件。卡瑞利珠单抗相关的孤立性展神经神经炎较为罕见。
我们报告了一名67岁的食管癌男性患者，在接受十个周期的卡瑞利珠单抗治疗后出现急性起病的孤立性右侧展神经麻痹。磁共振成像检查显示右侧展神经脑池段增粗且增强扫描有强化。诊断为卡瑞利珠单抗所致的免疫相关展神经神经炎。我们给予他口服逐渐减量的皮质类固醇（甲泼尼龙）治疗神经炎，未停用卡瑞利珠单抗。治疗一个月后，他完全康复。在复视发作一年后的最后一次随访中，患者状况良好，无神经症状复发。
展神经神经炎是卡瑞利珠单抗罕见的免疫相关不良后果。本病例证明了使用皮质类固醇治疗展神经神经炎的有效性和安全性。
