Nivolumab-Induced Neuromyopathy: A Case Report

Area of Science:

• Oncology
• Neurology
• Immunology

Background:

• Nivolumab is an immune checkpoint inhibitor (ICI) used to treat various cancers.
• While effective, ICIs can cause significant adverse side effects.
• Guillain-Barré syndrome is a rare neurological disorder affecting the peripheral nervous system.

Observation:

• A patient with stage III pharyngeal squamous cell carcinoma (SCC) on nivolumab developed quadriparesis.
• The patient presented with acute kidney failure and bilateral limb weakness, mimicking Guillain-Barré syndrome.
• Initial treatment with corticosteroids and IVIG showed minimal improvement.

Findings:

• The case highlights nivolumab-induced quadriparesis as a critical adverse event.
• This neurological complication can be life-threatening if not managed promptly and appropriately.
• The patient's presentation underscores the diagnostic challenge in differentiating ICI-related neuropathies.

Implications:

• Early recognition and intervention are vital for improving outcomes in patients experiencing nivolumab-induced neurological toxicity.
• A multidisciplinary team approach is recommended for optimal patient management.
• Prompt administration of corticosteroids may mitigate the severity of nivolumab-induced quadriparesis.