Case report: immune-mediated cerebellar ataxia secondary to anti-PD-L1 treatment for lung cancer
| Autor: | Yun Yi Tan, Nicola Steele, Kristiina Rannikmäe |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Antineoplastic Agents Hormonal Cerebellar Ataxia medicine.medical_treatment Prednisolone Antineoplastic Agents Antibodies Monoclonal Humanized Gastroenterology Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Internal medicine Carcinoma Non-Small-Cell Lung medicine Humans Lung cancer Aged Past medical history Cerebellar ataxia medicine.diagnostic_test business.industry Lumbar puncture General Neuroscience General Medicine Immunotherapy medicine.disease Clinical trial 030104 developmental biology Treatment Outcome medicine.symptom Differential diagnosis business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | The International journal of neuroscience. 129(12) |
| ISSN: | 1563-5279 |
| Popis: | Case presentation: A 66-year-old gentleman with metastatic non-small-cell lung cancer developed a wide-based gait following treatment on a clinical trial with cytotoxic chemotherapy and an anti-PD-L1 drug. He had no other significant past medical history of note. Brain imaging, blood tests and lumbar puncture did not reveal a structural, biochemical, paraneoplastic or infective cause. The main differential diagnoses were immune-mediated toxicity or a paraneoplastic syndrome. He was started on prednisolone on the suspicion that his symptoms represented an immune-mediated toxicity. His condition improved following this and his immunotherapy treatment was discontinued. Upon steroid withdrawal, his symptoms recurred and responded to further prednisolone. Conclusions: Immune-mediated toxicities can affect any part of the nervous system and should form part of the differential diagnosis for new neurological symptoms in a patient receiving immunotherapy. Corticosteroids should be the first-line treatment of immune-mediated toxicities. Immunotherapy should be permanently discontinued following severe toxicities. |
| Databáze: | OpenAIRE |
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