Paraneoplastic Anti-N-methyl-D-aspartate Receptor Encephalitis Associated with Small Cell Lung Cancer: A Dramatic...

Area of Science:

• Neurology
• Oncology
• Immunology

Background:

• Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis requires tumor management if refractory to immunosuppression.
• The efficacy of chemotherapy in neurologically compromised patients with malignant tumors is poorly understood.

Purpose of the Study:

• To report a case of anti-NMDAR encephalitis associated with small cell lung cancer (SCLC).
• To evaluate the effectiveness of chemotherapy, including atezolizumab, in a patient with severe neurological decline due to anti-NMDAR encephalitis and SCLC.

Main Methods:

• A 66-year-old male patient with anti-NMDAR encephalitis and SCLC was treated.
• Initial treatment with corticosteroid pulse therapy was ineffective.
• Subsequent treatment involved a chemotherapy regimen including atezolizumab.

Main Results:

• The patient presented with coma due to anti-NMDAR encephalitis linked to SCLC.
• Corticosteroid pulse therapy did not improve the neurological status.
• Chemotherapy with atezolizumab resulted in rapid neurological improvement.

Conclusions:

• Chemotherapy, specifically regimens containing atezolizumab, may offer rapid therapeutic benefits for anti-NMDAR encephalitis.
• This approach is particularly relevant when the encephalitis is associated with SCLC and refractory to standard immunosuppressive treatments.