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
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...
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| Format: | Article |
| Language: | English |
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Wiley
2024-11-01
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| Series: | Respirology Case Reports |
| Online Access: | https://doi.org/10.1002/rcr2.70070 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Lynn Nakahara |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-c5f80d01dcbe4496bc4983b58650fe76 |
| institution | Kabale University |
| issn | 2051-3380 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Respirology Case Reports |
| spelling | doaj-art-c5f80d01dcbe4496bc4983b58650fe762024-11-26T02:54:34ZengWileyRespirology Case Reports2051-33802024-11-011211n/an/a10.1002/rcr2.70070Immune 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 reviewLynn Nakahara0Shun Matsuura1Ryo Suzuki2Akira Kawamura3Takumi Nagasaki4Takafumi Masuda5Kotaro Yamada6Ryuuichi Nakamura7Toshiya Hiramatsu8Norimichi Akiyama9Kazuki Tanaka10Naoki Koshimizu11Shota Igasaki12Division of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDivision of Respiratory Internal Medicine Fujieda Municipal General Hospital Fujieda JapanDepartment of Stroke Neurology Fujieda Municipal General Hospital Fujieda JapanAbstract 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.https://doi.org/10.1002/rcr2.70070 |
| spellingShingle | 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 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 Respirology Case Reports |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://doi.org/10.1002/rcr2.70070 |
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