A Case of Anti-CRMP5 Paraneoplastic Neurological Syndrome Induced by Atezolizumab for Small Cell Lung Cancer

Intern Med. 2020 Aug 12. doi: 10.2169/internalmedicine.4889-20. Online ahead of print.

Abstract

We herein report a 76-year-old man who developed irritability and forgetfulness 5 months after the introduction of atezolizumab for the treatment of small cell lung cancer (SCLC). Brain magnetic resonance imaging showed lesions of the striatum, and an investigation of the serum revealed a high titer of anti-CRMP5 antibody. After stopping atezolizumab and starting steroid pulse therapy, these clinical features improved. Given these findings, it is considered that CRMP5-assciated striatal encephalitis was induced by atezolizumab in this case with SCLC.

Keywords: CRMP5; atezolizumab; immune-checkpoint inhibitors; irAE; paraneoplastic neurological syndrome.