Clinical case of complications of immunotherapy – encephalitis

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Abstract

Nowadays, checkpoint inhibitors are widely used in the treatment of various types of cancer. However, its’ use is often accompanied by the development of immune-mediated adverse events (IAEs) of various systems and organs. Aim – description of the features of the development of encephalitis during the treatment of small cell lung cancer (SCLC) using checkpoint inhibitors. There is a clinical case of a patient, who is receiving immunotherapy, with small cell carcinoma of the upper lobe of the left lung, stage IVA, cT2bN2M1a. The patient sought medical help in connection with complaints of an episode of memory loss, difficulty in remembering new information. Based on the clinical picture and examination data, a limbic encephalitis was diagnosed. Immune-related adverse events might affect any organ during all the period of therapy with checkpoint inhibitors. Physicians shall be aware of the risk of encephalitis development related to this type of anti-cancer therapy.

About the authors

Marina A. Lyadova

City Clinical Oncology Hospital №1

Email: dr.lyadova@gmail.com
ORCID iD: 0000-0002-9558-5579
SPIN-code: 8220-2854

Cand. Sci. (Med.), City Clinical Oncology Hospital №1

Russian Federation, Moscow

Olesya A. Kuchevskaya

City Clinical Oncology Hospital №1

Email: olesya.kuchevskaya@mail.ru
ORCID iD: 0000-0002-1568-8683

Oncologist, City Clinical Oncology Hospital №1

Russian Federation, Moscow

Evgeniya A. Kulikova

City Clinical Oncology Hospital №1

Author for correspondence.
Email: kulikovaEA14@zdrav.mos.ru
ORCID iD: 0000-0002-0319-4934
SPIN-code: 2884-4803

Department Head, City Clinical Oncology Hospital №1

Russian Federation, Moscow

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2. Fig. 1. Contrast-enhanced magnetic resonance imaging (MRI) of the brain (13.07.2022): a – diffuse increase in MR signal on T2 and flair sequences in the hippocampus on both sides; b – with intravenous contrast enhancement, the contrast uptake in the left hippocampus is visualized; the MR pattern is characteristic of limbic encephalitis.

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3. Fig. 2. Contrast-enhanced brain MRI (22.07.2022). A diffuse increase in MR signal on T2 and FLAIR sequences in the hippocampus on both sides (no change of MR pattern); MR pattern of limbic encephalitis remains unchanged in comparison with MRI of the brain dated 13.07.2022.

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