Abstract:
Chimeric antigen receptor (CAR-T) cell therapy is highly effective against hematological cancers but is associated with immune mediated side effects, including neurotoxicity. The most commonly described presentations of immune cell mediated neurotoxicity syndrome (ICANS) include cortical symptoms and generally localize to the central nervous system. In this report, we present a patient with acute onset of bilateral facial nerve palsy following CAR-T cell therapy, followed by a complete clinical recovery. Aside from a temporary anisocoria, he had no other neurologic symptoms and no encephalopathy or seizures. MRI Brain was non-contributory and cerebrospinal fluid revealed a modest increase in lymphocytes without systemic leukocytosis and viral studies were all negative. He was diagnosed with bilateral facial nerve palsy secondary to CAR-T cell therapy and subsequently treated with a course of steroids. Several weeks after presentation he returned to his neurological baseline. The presentation of CAR-T cell mediated facial nerve palsy is both clinically and scientifically relevant for physicians, patients, and researchers.
摘要:
嵌合抗原受体(CAR-T)细胞疗法对血液系统癌症非常有效,但与免疫介导的副作用有关。包括神经毒性.免疫细胞介导的神经毒性综合征(ICANS)的最常见表现包括皮质症状,通常位于中枢神经系统。在这份报告中,我们介绍了一个在CAR-T细胞治疗后急性发作的双侧面神经麻痹患者,随后是完全的临床恢复。除了暂时的不适,他没有其他神经系统症状,也没有脑病或癫痫发作。MRI大脑无贡献,脑脊液显示淋巴细胞适度增加,无系统性白细胞增多,病毒研究均为阴性。他被诊断为CAR-T细胞疗法继发的双侧面神经麻痹,随后接受了一个疗程的类固醇治疗。演示后几周,他恢复了他的神经基线。CAR-T细胞介导的面神经麻痹的表现对临床和科学都有重要意义。病人,和研究人员。