Pembrolizumab-associated autoimmune encephalitis in an elderly patient with advanced non-small cell lung cancer. A clinical case
DOI:
https://doi.org/10.23938/ASSN.0948Keywords:
Immune checkpoint inhibitors, Pembrolizumab, Comprehensive geriatric assessment, Encephalitis, ElderlyAbstract
Therapeutic objectives for the geriatric patient are improvement of quality of life and functional capacity rather than a mere increase in survival. In neoplastic disease, the decision to initiate administration of curative therapies, especially immunotherapy, should be taken only after any potential risks have been taken into account. Geriatric patients are more susceptible to developing more serious adverse reactions than the younger population.
We report the case of an octogenarian patient with non-small cell lung cancer who developed neurologic toxicity following pembrolizumab therapy. We carry out a differential diagnosis of encephalitis and provide a literature review of pembrolizumab-associated autoimmune encephalitis cases in order to improve our knowledge of this unusual toxicity. An interdisciplinary approach and comprehensive geriatric assessment are essential components to prevent functional decline in the elderly.
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SUSSMAN RM, MILLER J. Iodide mumps after intravenous urography. N Engl J Med 1956; 255: 433-434. https://doi.org/10.1056/nejm195608302550907
JIAO A, FARSAD K, MCVINNIE DW, JAHANGIRI Y, MORRISON JJ. Characterization of iodide-induced sialadenitis: Meta-analysis of the published case reports in the medical literature. Acad Radiol 2020; 27: 428-435. https://doi.org/10.1016/j.acra.2019.05.006
SÁNCHEZ-GARCÍA S, RUBIO-SOLÍS D, TERÁN-ÁLVAREZ L, CALVO-BLANCO J. Sialoadenitis aguda bilateral como reacción adversa a contraste yodado. Radiología 2018; 60: 171-174. https://doi.org/10.1016/j.rx.2017.05.002
CUÉLLAR J, HERNÁNDEZ F.DE ROJAS D, MUÑOZ-CANO A, GINER M, GÓMEZ J, BASOMBA A. Sialoadenitis aguda generalizada por medios de contraste yodado. A propósito de dos casos. Alergol Inmunol Clin 2000; 15: 406-409.
ZHANG G, LI T, WANG H, WANG H, LIU J: The pathogenesis of iodide mumps – A case report. Medicine (Baltimore) 2017; 96: e8881. https://doi.org/10.1097/md.0000000000008881
GILGEN-ANNER Y, HEIM M, LEDERMANN HP, BIRCHER AJ. Iodide mumps after contrast media imaging: a rare adverse effect to iodine. Ann Allergy Asthma Immunol 2007; 99: 93-98. https://doi.org/10.1016/s1081-1206(10)60628-x
LUCARELLI A, PERANDINI S, BORSATO A, STRAZIMIRI E, MONTEMEZZI S. Iodinated contrast-induced sialadenitis: a review of the literature and sonographic findings in a clinical case. J Ultrason 2018; 18: 359-364. https://doi.org/10.15557/jou.2018.0053
ACOSTA-OCHOA MI, VALENCIANO-MARTÍNEZ S, ALLER-APARICIO C, PALACIOS-PARADA A, RODRÍGUEZ-PORTELA G, PÉREZ-DÍAZ V et al. Sialadenitis por contraste. Nefrologia 2014; 34: 422-423.
AZEEMUDDIN M, CHAUDHRY MBH, SHAHID J, BELAL SZ. Non-ionic iodinated contrast-induced sialadenitis with parotid gland sparing in patient of hepatocellular carcinoma. Case Reports 2018; 2018: bcr-2017-222761. https://doi.org/10.1136/bcr-2017-222761
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