Clinical Diagnosis and Treatment Recommendations for Adverse Reaction in the Nervous System Related to Immunocheckpoint Inhibitor.
10.3779/j.issn.1009-3419.2019.10.05
- Author:
Jiayu SHI
1
;
Jingwen NIU
1
;
Dongchao SHEN
1
;
Yi LI
1
;
Mingsheng LIU
1
;
Ying TAN
1
;
Liying CUI
1
;
Yuzhou GUAN
1
;
Li ZHANG
2
Author Information
1. Departmet of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
2. Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
- Publication Type:Journal Article
- Keywords:
Immune checkpoint inhibitor;
Nervous system;
Steroids
- From:
Chinese Journal of Lung Cancer
2019;22(10):633-638
- CountryChina
- Language:Chinese
-
Abstract:
Immune checkpoint inhibitors (ICIs) can cause adverse reactions in the nervous system, with the incidence rate ranging from 0.1% to 12%, and 80% occurring within the first 4 months of ICI application. It can cause lesions in various parts of the nervous system, including aseptic meningitis, meningoencephalitis, necrotizing encephalitis, brainstem encephalitis, transverse myelitis and other central nervous system diseases. It can also cause cranial peripheral neuropathy, multifocal radicular neuropathy, Guillain-Barre syndrome, spinal radicular neuropathy and myasthenia gravis, myopathy, etc. For these complications of the nervous system, diagnosis could be made by sufficient collection of disease manifestations combined with imaging, cerebrospinal fluid examinations, electro-encephalogram or electro myography to exclude infection or tumor progression. In the treatment of severe cases, ICIs should be discontinued and treated with high doses of glucocorticoid or gamma globulin with systemic support. After neurological adverse reactions, the prognosis of severe cases is poor.
