Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.
Front Immunol. 2024 Sep 26;15:1451693. doi: 10.3389/fimmu.2024.1451693. eCollection 2024.
Daratumumab, a monoclonal antibody against CD38, is increasingly used in the treatment of multiple myeloma, other hematological malignancies and autoimmune diseases. Little is known about its CNS toxicity. We present a case of a patient with POEMS syndrome (syndrome of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes) who developed an acute leukoencephalopathy shortly after initiation of therapy with daratumumab.
Case report following the CARE case report guidelines.
The patient presented with symptoms of headache and diffuse worsening of a pre-existing tetraparesis. MRI showed a rapidly progressive leukoencephalopathy. Extensive diagnostic evaluation revealed no specific cause, suggesting the leukoencephalopathy to be caused by daratumumab.
Our report highlights a probably rare, but clinically significant adverse effect of daratumumab and underlines the necessity of raised vigilance for neurological side effects in patients treated with daratumumab.
达雷妥尤单抗是一种针对 CD38 的单克隆抗体，越来越多地用于治疗多发性骨髓瘤、其他血液系统恶性肿瘤和自身免疫性疾病。但其对中枢神经系统的毒性知之甚少。我们报告了一例 POEMS 综合征（多发性神经病、器官肿大、内分泌病、单克隆丙种球蛋白病和皮肤改变）患者，在开始使用达雷妥尤单抗治疗后不久发生急性脑白质病。
按照 CARE 病例报告指南进行病例报告。
患者表现为头痛，并伴有先前存在的四肢瘫痪进行性加重。MRI 显示出快速进展性脑白质病。广泛的诊断评估未发现特定原因，提示脑白质病是由达雷妥尤单抗引起的。
我们的报告强调了达雷妥尤单抗可能是一种罕见但具有临床意义的不良反应，并强调了在使用达雷妥尤单抗治疗的患者中必须提高对神经系统副作用的警惕。
