Autoimmune encephalitis associated with Ma2 antibodies and immune checkpoint inhibitor therapy. Issue 3 (17th April 2020)

• Record Type: Journal Article
• Authors: Lyons, Shane; Joyce, Ronan; Moynagh, Patrick; O'Donnell, Luke; Blazkova, Silive; Counihan, Timothy J
• Is Part Of: Practical neurology. Volume 20:Issue 3(2020)
• Page Start: 256
• Page End: 259
• Publication Date: 2020-04-17
• Subjects: immune checkpoint inhibitor -- anti-PD1 -- encephalitis; Neurology -- Periodicals; 616.8005
• DOI: 10.1136/practneurol-2019-002464
• Languages: English
• ISSNs: 1474-7758

Abstract

Abstract : 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.