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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
A Case Report of Steroid Responsive Nivolumab-Induced Encephalitis
Kaja Richard1, Jacqueline Weslow1, Stephanie L Porcella1
11 Department of Internal Medicine, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
Abstract:
Nivolumab (Opdivo) approval for the treatment of non-small cell lung cancer (NSCLC) prompts recognition of its future use in various cancers. Although rare, occurring in 1% to 3% of treated cases, nivolumab along with other immune checkpoint inhibitors are associated with immune-related encephalitis. With its prospective use, nivolumab-induced encephalitis illustrates the necessity of early recognition and successful management to decrease morbidity and mortality. We describe a treated case of nivolumab-induced encephalitis. A 74-year-old male with a history of stage 4 squamous NSCLC presenting with insidious altered mental status following his first dose of nivolumab. After an extensive workup that proved negative, the patient received intravenous steroids with gradual improvement of mental status. Patient subsequently returned to baseline and was discharged with oral steroid taper. Nivolumab-induced encephalitis is a diagnosis of exclusion with nonspecific signs and symptoms. Immediate recognition of patients prescribed nivolumab chemotherapy could potentially prevent fatal complications of neurotoxicity.
Insights
Nivolumab, an immunotherapy for lung cancer, can rarely cause immune-related encephalitis. Early recognition and steroid treatment are crucial for managing this rare side effect and preventing severe neurotoxicity.
Area of Science:
- Neuro-oncology
- Immunotherapy
- Oncology
Background:
- Nivolumab (Opdivo) is approved for non-small cell lung cancer (NSCLC) and may be used in other cancers.
- Immune checkpoint inhibitors like nivolumab can cause immune-related encephalitis in 1-3% of cases.
- Nivolumab-induced encephalitis necessitates early detection and management to reduce morbidity and mortality.
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