Guillain–Barre Syndrome-Like Polyneuropathy Induced by Immune Checkpoint Inhibitors: A Case Report

Over the past decade, immune checkpoint inhibitors (ICIs) have emerged as a crucial therapeutic option for treating various malignancies. Nivolumab, an ICI, is a monoclonal antibody directed against programmed cell death protein 1. However, many studies indicate that ICIs can lead to various immune-...

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Bibliographic Details
Main Authors: Bo-Kang Cheng, Chien-An Ko, Chun-Lin Kuo, Te-Chi Nai, Wei Lin, Chung-Hsing Chou, Yueh-Feng Sung
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Acta Neurologica Taiwanica
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Online Access:https://journals.lww.com/10.4103/ANT.ANT_112_0090
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Summary:Over the past decade, immune checkpoint inhibitors (ICIs) have emerged as a crucial therapeutic option for treating various malignancies. Nivolumab, an ICI, is a monoclonal antibody directed against programmed cell death protein 1. However, many studies indicate that ICIs can lead to various immune-related adverse events (irAEs), with neurological irAEs accounting for approximately 1%–5% of these cases. Neurological adverse events such as Guillain–Barre syndrome (GBS) are rare but life threatening. This report presents the case of a 72-year-old male diagnosed with sarcomatoid squamous cell carcinoma of the trachea, who was admitted with rapid-onset weakness of the upper limbs 7 days following the latest nivolumab treatment. These symptoms progressed quickly to quadriplegia and respiratory failure, requiring intubation and mechanical ventilation. Serum antiganglioside antibodies were positive for immunoglobulin (Ig) M-GM1, IgM-GD1b, and IgG-GM3. His clinical symptoms improved significantly after steroid and intravenous immunoglobulin treatment. This rare and atypical case highlights the complexity of ICI-related GBS. Early recognition of associated symptoms is crucial for timely and appropriate treatment.
ISSN:1028-768X