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
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
Entity: Universitat Rovira i Virgili
Journal publication year: 2017
Publication Type: Journal Publications
Repositori URV