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- Keisuke Shiraha, Hiromi Watanabe, Keiichi Fujiwara, Mayu Goda, Tomoyoshi Inoue, Miho Fujiwara, Suzuka Matsuoka, Yuki Takigawa, Sho Mitsumune, Kenichiro Kudo, Akiko Sato, Ken Sato, Yoko Shinno, and Takuo Shibayama.
- Department of Respiratory Medicine, NHO Okayama Medical Center, Japan.
- Intern. Med. 2024 Dec 15; 63 (24): 334533513345-3351.
AbstractA 75-year-old woman with stage IVB (cT2bN3M1b) lung adenocarcinoma was administered nivolumab, ipilimumab, carboplatin, and paclitaxel. Fourteen days after receiving chemotherapy, she experienced an impaired consciousness and a cerebrospinal fluid analysis revealed high protein levels and pleocytosis. She was diagnosed with nivolumab- and ipilimumab-induced encephalitis and was treated with corticosteroids which were tapered to 10 mg/day, with no symptom recurrence. She died 18 weeks after the initial presentation, as the cancer worsened. An autopsy showed encephalitis and CD8+ lymphocyte infiltration around the blood vessels. Thus, immune-related adverse events should be suspected and treatment should be initiated for patients presenting with an impaired consciousness when concurrently being treated with nivolumab and ipilimumab.
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