Abstract
Autoimmune encephalitis is an uncommon complication of immune checkpoint inhibitor therapy. This article reports a case of fatal anti-Hu-associated autoimmune limbic encephalitis presenting within 8 weeks following anti-PD1 therapy in a patient with myxoid chondrosarcoma and pre-existing anti-Hu antibodies. Although tumor reduction occurred in response to PD-1 inhibitor therapy, the patient had a rapidly progressive decline in neurologic function despite initial stabilization with immunosuppression. Considering the increasing use of immune checkpoint inhibitors for the treatment of various malignancies, an increase in the occurrence of neurologic adverse events is likely, requiring prompt intervention and enhanced pharmacovigilance in malignancies associated with onconeuronal antibodies.
© AlphaMed Press 2017.
MeSH terms
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Antibodies, Monoclonal / adverse effects*
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Antibodies, Monoclonal, Humanized
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Antineoplastic Agents, Immunological / adverse effects*
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Autoimmune Diseases / chemically induced
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Autoimmune Diseases / immunology
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Autoimmune Diseases / pathology*
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Chondrosarcoma / drug therapy*
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ELAV Proteins / immunology*
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Fatal Outcome
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Humans
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Limbic Encephalitis / chemically induced
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Limbic Encephalitis / immunology
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Limbic Encephalitis / pathology*
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Male
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Middle Aged
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Neoplasms, Connective and Soft Tissue / drug therapy*
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Programmed Cell Death 1 Receptor / antagonists & inhibitors*
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Humanized
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Antineoplastic Agents, Immunological
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ELAV Proteins
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PDCD1 protein, human
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Programmed Cell Death 1 Receptor
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cemiplimab
Supplementary concepts
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Autoimmune limbic encephalitis
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Chondrosarcoma, Extraskeletal Myxoid