061  T cell-mediated cerebellitis after ipilimumab for small cell lung cancer. Issue 6 (27th May 2022)

• Record Type: Journal Article
• Authors: Guillochon, Remi; Nolan, Luke; Nicoll, James; Jogai, Sanjay; Joseph-Pietras, Deborah; Arriola, Edurne; Ottensmeier, Christian; Galea, Ian
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 93:Issue 6(2022)
• Page Start: A31
• Page End: A31
• Publication Date: 2022-05-27
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2022-ABN.98
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Ipilimumab is an anti-CTLA4 antibody in evaluation for the treatment of small cell lung cancer. We report a case of rapidly progressive fatal cerebellitis occurring eight months after first dosing. Pre-treatment weakly positive anti-Yo antibodies did not change. Clinically asymptomatic anti-voltage-gated calcium channel antibodies developed after ipilimumab treatment, despite lack of expression by the tumour. The patient died three weeks into the neurological illness. Post-mortem examination revealed a T cell-mediated cerebellitis, with CD8 cytotoxicity towards Purkinje cells. This demonstrates the potential for CD8 T cells to trigger neuronal autoimmunity, offering insight into the early events in paraneoplastic neurological disease. [e-mail]