Otomo Kakeru, Fujita Masashi, Sekine Ryoji, Sato Hidenori, Abe Naoto, Sugaya Tatsuro, Watanabe Chiharu, Takahata Yosuke, Hayashi Manabu, Abe Kazumichi, Takahashi Atsushi, Ohira Hiromasa
Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan.
Intern Med. 2025 Apr 15;64(8):1181-1187. doi: 10.2169/internalmedicine.4321-24. Epub 2024 Sep 11.
A 65-year-old man treated with atezolizumab plus bevacizumab for hepatocellular carcinoma was admitted to our hospital with a fever, difficulty in moving, and aphasia. The patient became comatose immediately after admission. Imaging and cerebral fluid tests revealed no evidence of malignancy or infection. A diagnosis of atezolizumab-induced encephalitis was made, and steroid pulse therapy was initiated on admission, immediately after which the patient regained consciousness and was able to talk and walk. He was discharged with slight paralysis of his legs and was able to resume chemotherapy. An early diagnosis and treatment are required to improve the prognosis of encephalitis.
一名65岁男性因肝细胞癌接受阿替利珠单抗联合贝伐单抗治疗，因发热、行动困难和失语入住我院。患者入院后立即昏迷。影像学和脑脊液检查未发现恶性肿瘤或感染迹象。诊断为阿替利珠单抗诱发的脑炎，入院时即开始使用类固醇冲击疗法，此后患者立即恢复意识，能够说话和行走。患者出院时腿部有轻微瘫痪，能够恢复化疗。为改善脑炎的预后，需要早期诊断和治疗。
