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Updated: Aug 27, 2025
Induction and Diverse Assessment Indicators of Experimental Autoimmune Encephalomyelitis
Published on: September 9, 2022
An autopsy case of autoimmune meningoencephalitis caused by pembrolizumab
Yuhi Hiraoka1, Takaharu Ichikawa1, Norihiro Kusumi1
1Department of Urology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan.
Abstract:
A 91-year-old man was on his seventh course of pembrolizumab for recurrence of right renal pelvic cancer. On the 8th day of treatment, he was admitted to the hospital with idiopathic fever and malaise. On the 12th day, the patient experienced tonic convulsions and exhibited an impaired consciousness. Based on cerebrospinal fluid examination and the course of the disease, we diagnosed him with autoimmune meningoencephalitis as an immune-related adverse event triggered by pembrolizumab. We administered steroids, which restored the patient's consciousness. When he died of debility two months later, a pathological specimen was obtained, confirming the diagnosis of autoimmune meningoencephalitis.
Insights
Pembrolizumab, an immunotherapy for renal cancer, can trigger autoimmune meningoencephalitis. This rare immune-related adverse event caused severe neurological symptoms in a patient, which were partially reversed with steroid treatment.
Area of Science:
- Neuroimmunology
- Oncology
- Pharmacology
Background:
- Pembrolizumab is an immune checkpoint inhibitor used in cancer therapy.
- Immune-related adverse events (irAEs) are known complications of immunotherapy.
- Neurological irAEs, including meningoencephalitis, are rare but serious.
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