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Published on: November 5, 2019
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Cetuximab induced aseptic meningitis.
Summary
Aseptic meningitis is a rare side effect of cetuximab, a cancer drug. Symptoms like headache and fever appear soon after treatment, but patients usually recover quickly after stopping the medication.
Area of Science:
- Oncology
- Neurology
- Immunology
Background:
- Cetuximab, a monoclonal antibody targeting the epidermal growth factor receptor, is used for advanced oropharyngeal squamous cell carcinoma.
- Aseptic meningitis is a rare but serious potential adverse event associated with cetuximab therapy.
Observation:
- A 67-year-old man developed aseptic meningitis 9 hours after his first cetuximab dose.
- Literature review identified 5 additional cases with similar presentations.
Findings:
- Key symptoms include headache, neck stiffness, and fever within hours of initial cetuximab administration.
- Cerebrospinal fluid analysis revealed significant pleocytosis (528-2300 cells/μl) with neutrophil predominance (≥87%).
- Recovery occurred within 1-2 weeks with CSF normalization in 4-7 days.
Implications:
- Clinicians should be aware of aseptic meningitis as a potential rare complication of first-time cetuximab exposure.
- Cerebrospinal fluid analysis is crucial for diagnosis.
- While recovery is typically complete after drug withdrawal, re-challenge carries a risk of recurrence.
