Articles producció científica> Medicina i Cirurgia

Motor polyradiculopathy during pembrolizumab treatment of metastatic melanoma

  • Identification data

    Identifier: imarina:9293582
    Authors:
    Sepulveda, MariaMartinez-Hernandez, EugeniaGaba, LydiaVictoria, IvanSola-Valls, NuriaFalgas, NeusCasanova-Molla, JordiGraus, Francesc
    Abstract:
    IntroductionPembrolizumab, a monoclonal antibody directed against the immune checkpoint programmed cell death-1 receptor (PD-1), has improved survival in patients with advanced melanoma. Neuromuscular immune-mediated side effects have been rarely reported.MethodsWe describe a 44-year-old man with metastatic melanoma who presented with progressive muscle weakness after 23 doses of pembrolizumab.ResultsThe patient developed asymmetric, proximal muscle weakness and atrophy in all four limbs. Cerebrospinal fluid examination showed albuminocytologic dissociation. MRI revealed contrast enhancement of the lumbosacral roots. Electrodiagnostic studies demonstrated widespread fibrillation potentials in all four limbs, suggesting a generalized motor polyradiculopathy. Despite pembrolizumab discontinuation and treatment with steroids and intravenous immunoglobulin, limb weakness worsened. Electrodiagnostic studies were repeated, and showed marked and diffuse axonal motor damage. Seven weeks after clinical onset the patient was treated with plasma exchanges. He showed no further deterioration.DiscussionWe report a severe motor polyradiculopathy associated with an anti-PD-1 agent that expands the spectrum of neuromuscular complications of this class of drugs. Muscle Nerve56: E162-E167, 2017
  • Others:

    Author, as appears in the article.: Sepulveda, Maria; Martinez-Hernandez, Eugenia; Gaba, Lydia; Victoria, Ivan; Sola-Valls, Nuria; Falgas, Neus; Casanova-Molla, Jordi; Graus, Francesc;
    Department: Medicina i Cirurgia
    URV's Author/s: Casanova Mollà, Jordi
    Keywords: Toxic neuropathy Therapy Polyradiculoneuropathy Pembrolizumab Patient Nivolumab Myasthenia-gravis Multiple-sclerosis Ipilimumab treatment Immune neuropathy Guillain-barre-syndrome Cns demyelination Checkpoint Cancer Anti-programmed death-1 receptor
    Abstract: IntroductionPembrolizumab, a monoclonal antibody directed against the immune checkpoint programmed cell death-1 receptor (PD-1), has improved survival in patients with advanced melanoma. Neuromuscular immune-mediated side effects have been rarely reported.MethodsWe describe a 44-year-old man with metastatic melanoma who presented with progressive muscle weakness after 23 doses of pembrolizumab.ResultsThe patient developed asymmetric, proximal muscle weakness and atrophy in all four limbs. Cerebrospinal fluid examination showed albuminocytologic dissociation. MRI revealed contrast enhancement of the lumbosacral roots. Electrodiagnostic studies demonstrated widespread fibrillation potentials in all four limbs, suggesting a generalized motor polyradiculopathy. Despite pembrolizumab discontinuation and treatment with steroids and intravenous immunoglobulin, limb weakness worsened. Electrodiagnostic studies were repeated, and showed marked and diffuse axonal motor damage. Seven weeks after clinical onset the patient was treated with plasma exchanges. He showed no further deterioration.DiscussionWe report a severe motor polyradiculopathy associated with an anti-PD-1 agent that expands the spectrum of neuromuscular complications of this class of drugs. Muscle Nerve56: E162-E167, 2017
    Thematic Areas: Saúde coletiva Physiology (medical) Physiology Odontología Nutrição Neurosciences Neurology (clinical) Medicina veterinaria Medicina iii Medicina ii Medicina i Interdisciplinar General medicine Farmacia Ensino Engenharias iv Engenharias iii Engenharias ii Educação física Educação Clinical neurology Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Cellular and molecular neuroscience Biotecnología
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: jordi.casanova@urv.cat
    Author identifier: 0000-0003-0565-8015
    Record's date: 2024-09-07
    Papper version: info:eu-repo/semantics/acceptedVersion
    Link to the original source: https://onlinelibrary.wiley.com/doi/epdf/10.1002/mus.25672
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Muscle & Nerve. 56 (6): E162-E167
    APA: Sepulveda, Maria; Martinez-Hernandez, Eugenia; Gaba, Lydia; Victoria, Ivan; Sola-Valls, Nuria; Falgas, Neus; Casanova-Molla, Jordi; Graus, Francesc; (2017). Motor polyradiculopathy during pembrolizumab treatment of metastatic melanoma. Muscle & Nerve, 56(6), E162-E167. DOI: 10.1002/mus.25672
    Article's DOI: 10.1002/mus.25672
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2017
    Publication Type: Journal Publications
  • Keywords:

    Cellular and Molecular Neuroscience,Clinical Neurology,Neurology (Clinical),Neurosciences,Physiology,Physiology (Medical)
    Toxic neuropathy
    Therapy
    Polyradiculoneuropathy
    Pembrolizumab
    Patient
    Nivolumab
    Myasthenia-gravis
    Multiple-sclerosis
    Ipilimumab treatment
    Immune neuropathy
    Guillain-barre-syndrome
    Cns demyelination
    Checkpoint
    Cancer
    Anti-programmed death-1 receptor
    Saúde coletiva
    Physiology (medical)
    Physiology
    Odontología
    Nutrição
    Neurosciences
    Neurology (clinical)
    Medicina veterinaria
    Medicina iii
    Medicina ii
    Medicina i
    Interdisciplinar
    General medicine
    Farmacia
    Ensino
    Engenharias iv
    Engenharias iii
    Engenharias ii
    Educação física
    Educação
    Clinical neurology
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Cellular and molecular neuroscience
    Biotecnología
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