Immune ‐related aseptic meningitis diagnosed by Cube FLAIR on enhanced magnetic resonance imaging for a lung cancer patient administered atezolizumab: A case report

We present a case of immune-related aseptic meningitis that occurred following atezolizumab (PD-L1 inhibitor) treatment. The immune-related aseptic meningitis was diagnosed using MRI with the Gadolinium (Gd)- enhanced Cube fluid-attenuated inversion recovery (FLAIR) sequence. AbstractImmune checkpoint inhibitors (ICIs) can cause immune-related adverse events (irAEs), such as neurological toxicity. A 46-year-old man was diagnosed with squamous cell lung cancer. Lung cancer recurred 3  years after he experienced left segmental lung rejection. Therefore, he received atezolizumab as fourth-line chemotherapy. He experienced fever, headache, and decreased consciousness 10 days after the first dose of atezolizumab. Plain head computed tomography and cerebrospinal fluid examination showed no significant findings. Magnetic resonance imaging (MRI) with a Gadolinium (Gd)-enhanced Cube fluid-attenuated inversion recovery (FLAIR) sequence showed nodular abnormalities with contrast enhancement. Thus, aseptic meningitis caused by ICIs was suspected. His consciousness level gradually improved with glucocorticoid therapy. Moreover, most nodular abnormalities observed on cerebral MRI disappeared concurrently. Thus, Gd-enhanced Cube FLAIR sequence has the unique ability to reveal immune-related aseptic meningitis

Source: Respirology Case Reports - January 3, 2023 Category: Respiratory Medicine Authors: Ryo Kuroda, Hiroaki Nakagawa, Yasuki Uchida, Keiko Narumiya, Yoko Tsunoda, Masafumi Yamaguchi, Tatsuya Oki, Shinnosuke Hiratsuka, Yukihiro Nagatani, Yasutaka Nakano Tags: CASE REPORT Source Type: research