Bilateral tonic pupils secondary to anti-GD2 antibody therapy for neuroblastoma

Area of Science:

• Pediatric Oncology
• Neuro-Ophthalmology
• Immunotherapy Adverse Effects

Background:

• Neuroblastoma is a pediatric cancer treated with immunotherapies like dinutuximab.
• Dinutuximab targets the GD2 antigen, commonly found on neuroblastoma cells.
• Understanding immunotherapy side effects is crucial for patient management.

Observation:

• A 12-year-old girl with stage 4 neuroblastoma received dinutuximab treatment.
• Over six months, she developed bilateral chronic dilated pupils and reading difficulties.
• Clinical examination and pilocarpine testing confirmed tonic pupils.

Findings:

• Tonic pupils, a neurological condition affecting pupil response, were observed.
• The onset of tonic pupils correlated temporally with dinutuximab immunotherapy.
• This suggests a potential secondary effect of the anti-GD2 antibody treatment.

Implications:

• This case highlights a rare but significant adverse effect of dinutuximab.
• Ophthalmological monitoring may be warranted in patients receiving anti-GD2 therapies.
• Further research is needed to elucidate the mechanism of dinutuximab-induced tonic pupils.