Encephalitis Associated With Hemophagocytic Lymphohistiocytosis Secondary to Immune Checkpoint Inhibitors: An Unfamiliar Spin-Off
نویسندگان
چکیده
Checkpoint inhibitors (CPI) have become mainstream in standard therapy various tumors, especially malignant melanoma. Despite their widespread beneficial effects, these are also notorious for immune-related adverse events (irAEs). Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening syndrome of excessive immune activation. We report a case 33-year-old male having history metastatic melanoma on immunotherapy (status post two cycles ipilimumab/nivolumab) admitted persistent fever elevated liver enzymes. Additional work showed anemia, thrombocytopenia, hypertriglyceridemia, hyperferritinemia which meet the diagnostic criteria histiocyte society HLH-2004. The patient was effectively treated with oral prednisone. Moreover, further complications encompassed slurred speech, word-finding difficulties, ataxia, lower extremity hyperreflexia concerning autoimmune encephalitis. He high-dose IV methylprednisolone (1 gram/day 3 days) improvement symptoms. Autoimmune encephalitis associated HLH can be fatal - should considered, but this avenue still needs to explored.
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ژورنال
عنوان ژورنال: Cureus
سال: 2021
ISSN: ['2168-8184']
DOI: https://doi.org/10.7759/cureus.16079