A Rare Case of Autoimmune Demyelinating Polyneuropathy and Hydrocephalus Secondary to Pembrolizumab

J Investig Med High Impact Case Rep. 2020 Jan-Dec:8:2324709620916358. doi: 10.1177/2324709620916358.

Abstract

Pembrolizumab is a humanized monoclonal antibody that targets the programmed cell death 1 protein (PD-1) receptor and blocks the inhibitory checkpoint interaction between PD-1 and its ligands. This interaction leads to the upregulation of effector T-cells and downregulating regulatory T-cell production. Although this mechanism is essential for the management of cancer, it may lead to decreased self-tolerance with an autoimmune reaction toward healthy functioning tissue. One of the less commonly reported and less understood immune-related adverse events includes neuromuscular complications. We present a rare case of autoimmune demyelinating polyneuropathy and hydrocephalus secondary to pembrolizumab use for cutaneous squamous cell carcinoma of the cheek.

Keywords: AIDP; immune system; pembrolizumab; squamous cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antineoplastic Agents, Immunological / adverse effects*
  • Carcinoma, Squamous Cell / drug therapy
  • Humans
  • Hydrocephalus / chemically induced*
  • Hydrocephalus / diagnostic imaging
  • Magnetic Resonance Imaging
  • Male
  • Polyneuropathies / chemically induced*
  • Polyneuropathies / diagnostic imaging
  • Skin Neoplasms / drug therapy
  • T-Lymphocytes, Regulatory / drug effects
  • Tomography, X-Ray Computed

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological
  • pembrolizumab