• Internal medicine · Jul 2024

    Case Reports

    Small-cell Lung Carcinoma with Gastrointestinal Pseudo-obstruction as a Paraneoplastic Neurological Syndrome Elicited by an Immune Checkpoint Inhibitor.

    • Atsushi Saitou, Makoto Shioya, Yuta Nagahisa, Aoi Haseyama, Rumi Niwa, Jyuri Tsuchimoto, and Hirofumi Chiba.
    • Department of Respiratory Medicine, Otaru General Hospital, Japan.
    • Intern. Med. 2024 Jul 15; 63 (14): 205920622059-2062.

    AbstractGastrointestinal pseudo-obstruction (GIPO) is a phenotype of the paraneoplastic neurological syndrome (PNS). We herein report a case of small-cell lung carcinoma (SCLC) with GIPO elicited by an immune checkpoint inhibitor (ICI). A 75-year-old man with SCLC developed intractable intestinal obstruction after receiving one course of anticancer drugs (durvalumab, etoposide, and carboplatin). The serum anti-Hu antibody (Hu-Ab) was positive, and the patient was diagnosed with GIPO. Corticosteroid treatment did not improve the GIPO, and the patient died. There are few reports of GIPO after ICI treatment in patients with lung cancer, so a further investigation will be required to elucidate the mechanism by which ICIs elicit PNS. Checking for neuronal antibodies may help identify patients with SCLC who are at risk of developing PNS due to ICI treatment.

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