Karp B I, Yang J C, Khorsand M, Wood R, Merigan T C
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
Neurology. 1996 Aug;47(2):417-24. doi: 10.1212/wnl.47.2.417.
We reviewed the records and radiologic studies of eight patients who developed new focal neurologic abnormalities while receiving interleukin-2 (IL2)-based immunotherapy for malignancy or HIV infection. Initial confusion and delirium in the patients evolved into coma, ataxia, hemiparesis, seizures, and cortical syndromes including aphasia, apraxia, and cortical blindness. Imaging studies showed multiple white and gray matter lesions with a predilection for the occipital poles, centrum semiovale, and cerebellum. After cessation of IL2 treatment, seven patients improved to normal or near-normal neurologic function paralleled by resolution of the lesions on scans. One patient improved only minimally. Possible etiologies for the lesions include an IL2-induced cerebral vasculopathy, a direct toxic effect of IL2, or immunologically mediated damage.
我们回顾了8例患者的病历和影像学研究，这些患者在接受基于白细胞介素-2（IL2）的免疫治疗以治疗恶性肿瘤或HIV感染时出现了新的局灶性神经功能异常。患者最初的意识模糊和谵妄逐渐发展为昏迷、共济失调、偏瘫、癫痫发作以及包括失语、失用症和皮质盲在内的皮质综合征。影像学研究显示，在枕叶、半卵圆中心和小脑有多个白质和灰质病变。停用IL2治疗后，7例患者的神经功能恢复正常或接近正常，扫描显示病变消退。1例患者仅略有改善。这些病变的可能病因包括IL2诱导的脑血管病、IL2的直接毒性作用或免疫介导的损伤。
