Anti-γ-Aminobutyric Acid Type β Receptor Antibody-Associated Encephalitis After 2 Cycles of Durvalumab Therapy in a Patient with Small Cell Lung Cancer: A Case Report.
Anti-γ-Aminobutyric Acid Type β Receptor Antibody-Associated Encephalitis After 2 Cycles of Durvalumab Therapy in a Patient with Small Cell Lung Cancer: A Case Report.
复制标题
小细胞肺癌患者接受 2 个周期的 Durvalumab 治疗后出现抗 γ 氨基丁酸型 β 受体抗体相关性脑炎：病例报告
DOI：
10.2147/ott.s337331
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发表时间：
2021
影响因子：
4
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Li J;Jiang J;Lv J;Zhang R;Chen W;Li S;Jin Q;Wang G
抗γ-氨基丁酸型β受体抗体相关性脑炎是自身免疫性脑炎的一种。根据目前的文献报道，其发病机制与肿瘤因素密切相关。然而，由于病例罕见，临床认识有限，临床表现和影像表现缺乏特异性，诊断可能很困难。临床试验表明，免疫治疗可以延长小细胞肺癌患者的生存时间，但在某些情况下，免疫治疗可能会导致抗GABABR抗体相关性脑炎。在免疫治疗期间患上这种脑炎的患者往往会推迟治疗，因为病因还不清楚。在这项研究中，我们报告一例61岁男性，确诊为小细胞肺癌，在接受阿斯利康联合化疗两个周期后，出现急性认知功能障碍和癫痫发作。这种反应最初被认为是杜伐单抗治疗引起的免疫相关不良事件(IRAE)，最终患者被认为患有由原发肿瘤引起的副肿瘤性神经疾病。这份报告提高了人们对小细胞肺癌患者认知障碍和癫痫症状的认识，以及与免疫治疗相关的可能的不良事件。该病例还强调了在小细胞肺癌患者中检测抗GABABR抗体的重要性。
Anti-γ-aminobutyric acid type β receptor (anti-GABABR) antibody-associated encephalitis is a type of autoimmune encephalitis. According to current literature, its pathogenesis is reported to be closely related to tumor factors. However, diagnosis can be difficult because of the rarity of cases, limited clinical understanding, and a lack of specificity in clinical manifestation and imaging presentation. Clinical trials have demonstrated that immunotherapy can prolong the survival of patients with small cell lung cancer; however, in some cases, immunotherapy may induce anti-GABABR antibody-associated encephalitis. Patients who develop this encephalitis during immunotherapy often delay treatment because the cause is not clearly identified. In this study, we report a case of a 61-year-old man with a confirmed diagnosis of small cell lung cancer who had acute onset of cognitive impairment and seizures after two cycles of durvalumab (AstraZeneca UK Limited) combination chemotherapy. This reaction was initially considered as an immune-related adverse event (irAE) caused by durvalumab treatment, and the patient was eventually considered to have a paraneoplastic neurological disorder caused by the primary tumor. This report raises awareness of the symptoms of cognitive impairment and seizures in patients with small cell lung cancer, and the possible adverse events associated with immunotherapy. This case also highlights the importance of detecting anti-GABABR antibodies in patients with small cell lung cancer.