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Pract Neurol ; 20(3): 256-259, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32303632

RESUMEN

Immune checkpoint inhibitors have transformed the treatment of advanced malignancy, while increasing the risk of immune-related adverse events. A 56-year-old woman who had received nivolumab for stage 4 renal cell carcinoma subsequently developed altered behaviour, memory deficits and worsening of previously stable epilepsy. MR scan of the brain showed bilateral FLAIR (fluid-attenuated inversion recovery) hyperintensity of the mesial temporal lobes, and there were anti-Ma2 antibodies in both serum and cerebrospinal fluid. She was treated with corticosteroids but developed further clinical relapses requiring immunoglobulin and rituximab. The immune-related adverse events relating to immune checkpoint inhibitors are an emerging challenge for the neurologist. Some cases are refractory and require serial immunosuppression.


Asunto(s)
Antígenos de Neoplasias/metabolismo , Autoanticuerpos/metabolismo , Encefalitis/tratamiento farmacológico , Encefalitis/metabolismo , Enfermedad de Hashimoto/tratamiento farmacológico , Enfermedad de Hashimoto/metabolismo , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Proteínas del Tejido Nervioso/metabolismo , Autoanticuerpos/efectos de los fármacos , Encefalitis/diagnóstico por imagen , Femenino , Enfermedad de Hashimoto/diagnóstico por imagen , Humanos , Inhibidores de Puntos de Control Inmunológico/farmacología , Persona de Mediana Edad
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