一名子宫内膜癌患者发生的帕博利珠单抗相关格林-巴利综合征：病例报告
Pembrolizumab-associated Guillain-Barre syndrome in a patient with endometrial cancer: A case report.
作者信息
Gleason Emily, Pollie Meridith, Satish Sanjana, Li Sue, Tanyi Janos L
机构信息
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA.
出版信息
Gynecol Oncol Rep. 2025 Jul 28;60:101816. doi: 10.1016/j.gore.2025.101816. eCollection 2025 Aug.
OBJECTIVE
Guillain-Barré syndrome (GBS) is a rare yet potentially life-threatening adverse event of immune checkpoint inhibitors (ICI). It classically presents with ascending symmetric weakness, areflexia, and distal sensory loss. We present a case of pembrolizumab-induced GBS in a patient with advanced endometrial cancer.
METHODS
All information was obtained via chart review with patient consent.
RESULTS
A 77-year-old female with stage IIIC1 grade 3 endometrioid endometrial cancer received received carboplatin, paclitaxel, and pembrolizumab. After 5 cycles, she developed progressive bilateral lower-extremity paresthesias, sensory loss, areflexia, and distal weakness. Lumbar puncture demonstrated albuminocytologic dissociation, and electromyography confirmed acute inflammatory demyelinating polyneuropathy. Pembrolizumab was discontinued, and the patient received intravenous immunoglobulin with improvement.
CONCLUSION
This case highlights the importance of early recognition of GBS. ICI discontinuation and rapid initiation of treatment are essential to avoid life-threatening complications and optimize patient outcomes.
目的
吉兰 - 巴雷综合征（GBS）是免疫检查点抑制剂（ICI）罕见但可能危及生命的不良事件。其典型表现为进行性对称性肌无力、腱反射消失和远端感觉丧失。我们报告一例晚期子宫内膜癌患者发生帕博利珠单抗诱导的GBS病例。
方法
所有信息均在患者同意后通过病历审查获得。
结果
一名77岁的IIIC1期3级子宫内膜样腺癌女性接受了卡铂、紫杉醇和帕博利珠单抗治疗。5个周期后，她出现了进行性双侧下肢感觉异常、感觉丧失、腱反射消失和远端肌无力。腰椎穿刺显示蛋白细胞分离，肌电图证实为急性炎症性脱髓鞘性多发性神经病。停用帕博利珠单抗，患者接受静脉注射免疫球蛋白后病情改善。
结论
本病例强调了早期识别GBS的重要性。停用ICI并迅速开始治疗对于避免危及生命的并发症和优化患者预后至关重要。
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