Abstract

Immune checkpoint inhibitor-related neurotoxicity causing Guillain Barre Syndrome is relatively uncommon. We discussed an 80-year-old patient with known systemic lupus erythematosus who presented with lower extremity weakness, areflexia and then progressed to respiratory muscle and upper extremity weakness after receiving immunotherapy with checkpoint inhibitors for metastatic bladder cancer. With the increasing use of immunotherapy for the management of cancer, awareness of neurological autoimmune side effects is essential. Immune checkpoint inhibitor-mediated GBS can be severe and fatal if not diagnosed promptly. The hospitalists, neurologists, and oncologists should be aware of neurotoxicity related to immune checkpoint inhibitor therapy requiring a multidisciplinary approach to patient care. Prompt initiation of immunosuppressive therapy is required for the management of immune checkpoint inhibitor-related neurotoxicity.

Details

Title
Pembrolizumab related Guillain barre syndrome, a rare presentation in a patient with a history of lupus and bladder cancer
Author
Sangani, Vikram 1   VIAFID ORCID Logo  ; Pokal, Mytri 1   VIAFID ORCID Logo  ; Balla, Mamtha 2   VIAFID ORCID Logo  ; Ganesh Prasad Merugu 3   VIAFID ORCID Logo  ; Adapa, Sreedhar 4   VIAFID ORCID Logo  ; Naramala, Srikanth 5   VIAFID ORCID Logo  ; Konala, Venu Madhav 6 

1  Hospitalist, Department of Internal Medicine, Quantum HC, Macon, Georgia 
2  Clinical Assistant Professor, Department of Internal Medicine, University of Toledo and Promedica Toledo Hospital, Toledo, USA 
3  Division Chief and Geriatric Fellowship Program Director, Division of Geriatric Medicine, Department of Family Medicine, University of Toledo, Toledo, USA 
4  Department of Internal Medicine, Division of Nephrology, Adventist Medical Center, Hanford, USA 
5  Department of Internal Medicine, Division of Rheumatology, Adventist Medical Center, Hanford, USA 
6  Department of Internal Medicine, Division of Medical Oncology, Ashland Bellefonte Cancer Center, Ashland, USA 
Pages
388-392
Publication year
2021
Publication date
May 2021
Publisher
Greater Baltimore Medical Center
e-ISSN
20009666
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1080/20009666.2021.1903133
ProQuest document ID
2524574450
Copyright
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center. This work is licensed under the Creative Commons  Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.