Pre-existing Lambert-Eaton Myasthenic Syndrome and Scleroderma in a Patient with Neuroendocrine Carcinoma Undergoing Immune Checkpoint Inhibitor Cancer Immunotherapy

IF 2.9 4区医学 Q3 IMMUNOLOGY

Journal of neuroimmunology Pub Date : 2024-11-12 DOI:10.1016/j.jneuroim.2024.578485

Nisa Vorasoot , Thorvardur R. Halfdanarson , Nicolas N. Madigan , Divyanshu Dubey , Uma Thanarajasingam , Anastasia Zekeridou

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引用次数: 0

Abstract

Introduction

Paraneoplastic neurological syndromes (PNS) can worsen with immune checkpoint inhibitor (ICI) cancer immunotherapy.

Case report

A 66-year-old female with paraneoplastic Lambert-Eaton Myasthenic Syndrome (LEMS), which led to the diagnosis of metastatic neuroendocrine carcinoma, was treated with intravenous immune globulin (IVIg) (with minimal response), chemotherapy, and radiation, resulting in neurological improvement. However, sclerodermatous changes developed after a year. Due to cancer progression, dual ICI therapy was initiated, and the patient remained stable for eight months until the progression of both LEMS and cancer, ultimately leading to death.

Discussion

This case highlights the challenges of managing pre-existing PNS during ICI therapy, emphasizing the need for a multidisciplinary approach and the consideration of unusual clinical presentations in therapeutic decision-making.

查看原文本刊更多论文

接受免疫检查点抑制剂癌症免疫疗法的神经内分泌癌患者原有的兰伯特-伊顿氏肌萎缩综合征和硬皮病

导言：副肿瘤性神经综合征（PNS）会随着免疫检查点抑制剂（ICI）癌症免疫疗法而恶化：一名66岁的女性患者患有副肿瘤性兰伯特-伊顿肌萎缩综合征（LEMS），诊断为转移性神经内分泌癌，患者接受了静脉注射免疫球蛋白（IVIg）（反应微弱）、化疗和放疗，神经系统症状有所改善。然而，一年后出现了硬皮病变。由于癌症进展，患者开始接受双 ICI 治疗，病情稳定了八个月，直到 LEMS 和癌症同时进展，最终导致死亡：本病例凸显了在 ICI 治疗期间管理原有 PNS 所面临的挑战，强调了多学科方法的必要性，以及在治疗决策中考虑异常临床表现的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of neuroimmunology 医学-免疫学

CiteScore

6.10

自引率

3.00%

发文量

154

审稿时长

37 days

期刊介绍： The Journal of Neuroimmunology affords a forum for the publication of works applying immunologic methodology to the furtherance of the neurological sciences. Studies on all branches of the neurosciences, particularly fundamental and applied neurobiology, neurology, neuropathology, neurochemistry, neurovirology, neuroendocrinology, neuromuscular research, neuropharmacology and psychology, which involve either immunologic methodology (e.g. immunocytochemistry) or fundamental immunology (e.g. antibody and lymphocyte assays), are considered for publication.