奥法妥木单抗治疗免疫检查点抑制剂相关副肿瘤性小脑性共济失调综合征1例  

A case of paraneoplastic cerebellar ataxia syndrome associated with immunocheckpoint inhibitor treated with Ofatumumab

作　　者：刘雅菁 冯双浩 江佳佳 杨伊 卜晖[1] LIU Yajing;FENG Shuanghao;JIANG Jiajia;YANG Yi;BU Hui(Department of Neurology,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院神经内科,石家庄050000

出　　处：《中国神经精神疾病杂志》2024年第3期159-161,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：报告应用奥法妥木单抗(Ofatumumab,OFA)治疗免疫检查点抑制剂(immune checkpoint inhibitors,ICI)引起的副肿瘤性小脑性共济失调综合征1例。患者,男,57岁,既往小细胞肺癌病史,应用“卡瑞丽珠单抗”免疫治疗,主因“行走不稳1年余,头部不自主晃动1月余”入院。入院后完善头颅核磁、胸部CT、脑电图、腰椎穿刺等相关检查,副肿瘤综合征抗体谱抗GAD65抗体IgG(+),确诊免疫检查点抑制剂相关神经系统副肿瘤综合征(paraneoplastic neurological syndromes,PNS),给予OFA治疗(20mg/次)后症状明显改善。本文通过分析该病例的临床特点及诊疗思路,以提高临床医师对该疾病的认识,为类似病例的临床诊治提供参考。A case of paraneoplastic cerebellar ataxia syndrome caused by immune checkpoint inhibitors(ICI)was treated with ofatumumab(OFA).The patient is a 57-year-old male.He used“Camrelizumab”immunotherapy for his previous history of small cell lung cancer.The main reason was“walking unsteadily for more than one year and shaking his head involuntarily for more than one month”.After admission,the head MRI,chest CT,electroencephalogram,lumbar puncture and other related examinations were improved.The antibody spectrum of paraneoplastic neurological syndrome was anti-GAD65 antibody IgG(+),and the case was then diagnosed as the immune checkpoint inhibitor-related paraneoplastic neurological syndromes(PNS)of nervous system.After OFA treatment(20 mg/time),the symptoms were obviously improved.This paper analyzes the clinical features and diagnosis and treatment approaches of this case,in order to improve clinicians'understanding of the disease and provide reference for clinical diagnosis and treatment of similar cases.

关 键 词：奥法妥木单抗 神经系统副肿瘤综合征 免疫检查点抑制剂 小脑共济失调 CD20单克隆抗体 

分 类 号：R741[医药卫生—神经病学与精神病学]