Open AccessRenal cell carcinoma with central nervous system demyelination caused by nivolumab
Author(s) -
Oka Toshiki,
Yamamoto Yoshiyuki,
Okuda Yohei,
Asakura Toshihisa,
Hatano Koji,
Nakai Yasutomo,
Nakayama Masashi,
Kakimoto Kenichi,
Sugai Fuminobu,
Nishimura Kazuo
Publication year - 2021
Publication title -
iju case reports
Language(s) - English
Resource type - Journals
ISSN - 2577-171X
DOI - 10.1002/iju5.12234
Subject(s) - nivolumab , renal cell carcinoma , medicine , central nervous system , magnetic resonance imaging , white matter , pathology , immunotherapy , radiology , cancer
Central nervous system demyelination caused by immune checkpoint inhibitors is a very rare condition. Case presentation A 65‐year‐old man who received nivolumab for renal cell carcinoma developed abnormal behavior, such as disagreeable speech and sudden anger. Brain‐enhanced magnetic resonance imaging revealed multiple lesions with partial contrast effects in the cerebral white matter. We tentatively diagnosed demyelination caused by nivolumab, and performed steroid pulse therapy twice. After that, his symptoms improved. For the next 2 years, his symptoms did not recur, nor did his cancer progress. Conclusion Demyelination caused by immune checkpoint inhibitors can be fatal and requires early diagnosis and treatment.