Guillain-Barre Syndrome-Like Polyneuropathy Induced by Immune Checkpoint Inhibitors: A Case Report

Area of Science:

• Oncology
• Neurology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) are vital cancer therapies.
• Neurological immune-related adverse events (irAEs) from ICIs are rare (1-5%) but serious.
• Guillain-Barre syndrome (GBS) is a rare, life-threatening neurological irAE.

Purpose of the Study:

• To report a rare case of GBS following nivolumab treatment.
• To highlight the diagnostic and therapeutic challenges of ICI-related GBS.
• To emphasize the importance of early recognition for prompt management.

Main Methods:

• Case report of a 72-year-old male with sarcomatoid squamous cell carcinoma.
• Clinical presentation of rapid-onset limb weakness post-nivolumab therapy.
• Diagnostic workup including serum antiganglioside antibodies (IgM-GM1, IgM-GD1b, IgG-GM3).

Main Results:

• Patient developed quadriplegia and respiratory failure requiring mechanical ventilation.
• Positive findings for IgM-GM1, IgM-GD1b, and IgG-GM3 antiganglioside antibodies.
• Significant clinical improvement after treatment with steroids and intravenous immunoglobulin.

Conclusions:

• This case illustrates an atypical presentation of nivolumab-induced GBS.
• Prompt diagnosis and treatment are crucial for managing this rare neurological complication.
• Awareness of ICI-related neurological irAEs is essential for oncologists and neurologists.