Autoimmune encephalitis associated with Ma2 antibodies and immune checkpoint inhibitor therapy
| Autor: | Ronan Joyce, Timothy J. Counihan, Silive Blazkova, Patrick Moynagh, Luke Francis O'Donnell, Shane Lyons |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_treatment
Nerve Tissue Proteins Hashimoto Disease Fluid-attenuated inversion recovery 03 medical and health sciences Epilepsy 0302 clinical medicine Antigens Neoplasm Humans Medicine Adverse effect Immune Checkpoint Inhibitors Autoantibodies Autoimmune encephalitis biology business.industry Immunosuppression General Medicine Middle Aged medicine.disease 030220 oncology & carcinogenesis Immunology biology.protein Encephalitis Female Rituximab Neurology (clinical) Antibody Nivolumab business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Practical Neurology. 20:256-259 |
| ISSN: | 1474-7766 1474-7758 |
| DOI: | 10.1136/practneurol-2019-002464 |
| Popis: | Immune checkpoint inhibitors have transformed the treatment of advanced malignancy, while increasing the risk of immune-related adverse events. A 56-year-old woman who had received nivolumab for stage 4 renal cell carcinoma subsequently developed altered behaviour, memory deficits and worsening of previously stable epilepsy. MR scan of the brain showed bilateral FLAIR (fluid-attenuated inversion recovery) hyperintensity of the mesial temporal lobes, and there were anti-Ma2 antibodies in both serum and cerebrospinal fluid. She was treated with corticosteroids but developed further clinical relapses requiring immunoglobulin and rituximab. The immune-related adverse events relating to immune checkpoint inhibitors are an emerging challenge for the neurologist. Some cases are refractory and require serial immunosuppression. |
| Databáze: | OpenAIRE |
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