Immune checkpoint inhibitor-induced autoimmune limbic encephalitis with positivity for anti-Hu antibodies in a patient with small-cell lung cancer: A case report and literature review.

IF 0.8 Q4 RESPIRATORY SYSTEM
Respirology Case Reports Pub Date : 2024-11-25 eCollection Date: 2024-11-01 DOI:10.1002/rcr2.70070
Lynn Nakahara, Shun Matsuura, Ryo Suzuki, Akira Kawamura, Takumi Nagasaki, Takafumi Masuda, Kotaro Yamada, Ryuuichi Nakamura, Toshiya Hiramatsu, Norimichi Akiyama, Kazuki Tanaka, Naoki Koshimizu, Shota Igasaki
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引用次数: 0

Abstract

In recent years, there has been an increasing number of studies on neurological symptoms induced as paraneoplastic neurological syndrome (PNS) or neurological immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitors (ICIs). Herein, we report a 68-year-old male patient with small-cell lung cancer who developed memory impairment and autonomic nervous system dysfunction after three courses of carboplatin, etoposide, and durvalumab therapy. Brain magnetic resonance imaging revealed hyperintense areas restricted to the bilateral temporal lobes. Moreover, based on the blood test results, the patient was strongly positive for anti-neuronal nuclear antibodies. Hence, he was diagnosed with autoimmune limbic encephalitis (ALE). Corticosteroid pulse therapy was administered. After treatment, the patient exhibited gradual improvement in memory impairment. However, while tapering the prednisolone dose, the patient exhibited relapse of memory disturbance owing to ALE. It is challenging to distinguish PNS from neurological irAEs. However, ICI-induced ALE with positivity for anti-Hu antibodies has an extremely poor prognosis.

小细胞肺癌患者因免疫检查点抑制剂诱发自身免疫性边缘脑炎并伴有抗Hu抗体阳性:病例报告和文献综述。
近年来,有关免疫检查点抑制剂(ICIs)治疗患者诱发的副肿瘤性神经综合征(PNS)或神经系统免疫相关不良事件(irAEs)等神经系统症状的研究越来越多。在此,我们报告了一名 68 岁的男性小细胞肺癌患者,他在接受了三个疗程的卡铂、依托泊苷和杜伐单抗治疗后出现了记忆障碍和自主神经系统功能障碍。脑磁共振成像显示,高强度区域局限于双侧颞叶。此外,根据血液检测结果,患者的抗神经元核抗体呈强阳性。因此,他被诊断为自身免疫性边缘脑炎(ALE)。患者接受了皮质类固醇脉冲治疗。治疗后,患者的记忆障碍逐渐改善。然而,在减少泼尼松龙剂量的同时,患者因自身免疫性边缘脑炎而导致的记忆障碍复发。区分 PNS 和神经系统的非过敏性反应具有挑战性。然而,ICI诱发的抗Hu抗体阳性的ALE预后极差。
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来源期刊
Respirology Case Reports
Respirology Case Reports RESPIRATORY SYSTEM-
CiteScore
1.40
自引率
0.00%
发文量
178
审稿时长
8 weeks
期刊介绍: Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.
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