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Updated: May 10, 2026
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Dynamic Imaging of Chimeric Antigen Receptor T Cells with [18F]Tetrafluoroborate Positron Emission Tomography/Computed Tomography
Published on: February 17, 2022
From orbit to cortex: recognising teprotumumab-induced encephalopathy
Alan Spicer1, Zuhair Siddiqui2, Ping-Hao Yang2
1College of Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA arspicer@usf.edu.
BMJ Case Reports
|May 8, 2026
Summary
Monoclonal antibody therapy, like teprotumumab, can rarely cause autoimmune encephalopathy. This case highlights neuropsychiatric changes and successful treatment with plasma exchange for this rare adverse effect.
Area of Science:
- Neurology
- Immunology
- Ophthalmology
Background:
- Autoimmune-related adverse effects are known complications of monoclonal antibody therapies.
- Autoimmune encephalopathy is an uncommon but serious neurological side effect.
- Insulin-like growth factor 1 (IGF-1) pathway inhibition is associated with neurocognitive side effects.
Purpose of the Study:
- To report a rare case of autoimmune encephalopathy induced by teprotumumab.
- To describe the clinical presentation and management of teprotumumab-induced encephalopathy.
- To increase awareness of potential neurocognitive adverse effects of teprotumumab.
Main Methods:
- Case report of a male patient in his early 60s.
- Clinical presentation of neuropsychiatric changes following teprotumumab initiation for thyroid eye disease.
- Diagnosis of teprotumumab-induced encephalopathy.
- Treatment with plasma exchange.
Main Results:
- The patient developed significant neuropsychiatric changes after starting teprotumumab.
- Teprotumumab-induced encephalopathy was diagnosed.
- Plasma exchange resulted in successful treatment and resolution of symptoms.
Conclusions:
- Teprotumumab, a monoclonal antibody targeting the IGF-1 pathway, can rarely lead to autoimmune encephalopathy.
- Neuropsychiatric symptoms should be monitored in patients receiving teprotumumab.
- Plasma exchange is an effective treatment for teprotumumab-induced encephalopathy.
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