医学
重症肌无力
肌炎
多神经根神经病
无菌性脑膜炎
不利影响
疾病
中止
慢性炎症性脱髓鞘性多发性神经病
脑膜脑炎
免疫学
重症监护医学
格林-巴利综合征
儿科
内科学
脑膜炎
抗体
作者
Morinobu Seki,Shigeaki Suzuki
出处
期刊:PubMed
[National Institutes of Health]
日期:2021-01-01
卷期号:73 (1): 35-46
被引量:1
标识
DOI:10.11477/mf.1416201710
摘要
Neurological immune-related adverse events (irAEs) associated with cancer treatment with immune checkpoint inhibitors (ICIs) are infrequent but are sometimes serious and require prompt diagnosis and management. Among diverse clinical subsets, meningoencephalitis, polyradiculoneuropathy, myasthenia gravis, and myositis are particularly important. The clinical presentation may be different from that of patients with those conditions unrelated to ICIs. A broad range of clinical symptoms complicates the diagnosis of autoimmune encephalitis. The clinical features of aseptic meningitis induced by classical drugs and ICIs are different. Polyradiculoneuropathy, usually diagnosed as Guillain-Barré syndrome or chronic inflammatory demyelinating polyneuropathy, requires prompt diagnosis. However, the clinical manifestations and laboratory findings of patients with polyradiculoneuropathy may be unique and differ from those in the preexisting disease subset. Although myasthenia gravis and myositis are usually independent diseases, it is often difficult to diagnose myasthenia gravis or myositis independently when the disease is associated with irAEs. We believe that inflammatory myopathy associated with ICIs is a novel disease entity accompanied by possible biomarkers of anti-striational antibodies. Discontinuation of immune checkpoint inhibitors and steroid treatment is recommended with a good response. A correct understanding of neurological adverse events is required for the best management of cancer patients.
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