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BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Case report

Neuromyelitis optica spectrum disorder secondary to treatment with anti-PD-1 antibody nivolumab: the first report

Authors: Yoshitsugu Narumi, Ryohei Yoshida, Yoshinori Minami, Yasushi Yamamoto, Shiori Takeguchi, Kohei Kano, Kae Takahashi, Tsukasa Saito, Jun Sawada, Hiroya Terui, Takayuki Katayama, Takaaki Sasaki, Yoshinobu Ohsaki

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

Immune checkpoint blockade is developed as standard treatment for non-small cell lung cancer. However immune-related adverse events (irAE) have still unknown complications. Here, we report a patient with lung squamous cell carcinoma who developed neuromyelitis optica spectrum disorder with nivolumab.

Case presentation

A 75-year-old Japanese man with lung squamous cell carcinoma was administered nivolumab as second-line treatment. Two months after treatment with nivolumab, he presented acute paralysis in the bilateral lower limbs, sensory loss. Spinal magnetic resonance imaging showed T2 hyperintense lesions between C5-6 and Th12-L1. He was diagnosed with neuromyelitis optica spectrum disorder (NMOSD) by anti-aquaporin-4 antibody-positive in the serum and other examinations. After treatment, steroid reactivity was poor.

Conclusion

This is the first patient who developed anti-AQP4 antibody-positive NMOSD as a nivolumab-induced irAE. Clinicians should be aware of this kind of potential neurological complication by using immune check point inhibitor and start the treatment of this irAE as soon as possible.
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Metadata
Title
Neuromyelitis optica spectrum disorder secondary to treatment with anti-PD-1 antibody nivolumab: the first report
Authors
Yoshitsugu Narumi
Ryohei Yoshida
Yoshinori Minami
Yasushi Yamamoto
Shiori Takeguchi
Kohei Kano
Kae Takahashi
Tsukasa Saito
Jun Sawada
Hiroya Terui
Takayuki Katayama
Takaaki Sasaki
Yoshinobu Ohsaki
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-3997-2

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