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Pembrolizumab‑induced aseptic meningitis in a patient with non‑small cell lung cancer: A case report and literature review of aseptic meningitis as an immune‑related adverse event

  • Authors:
    • Genki Inui
    • Yoshihiro Funaki
    • Haruhiko Makino
    • Hirokazu Touge
    • Katsunori Arai
    • Keisuke Kuroda
    • Yuuki Hirayama
    • Ryohei Kato
    • Takafumi Nonaka
    • Kohei Yamane
    • Yasuhiko Teruya
    • Yuriko Sueda
    • Tomohiro Sakamoto
    • Kosuke Yamaguchi
    • Masahiro Kodani
    • Shinya Kawase
    • Yoshihisa Umekita
    • Yasushi Horie
    • Kanae Nosaka
    • Akira Yamasaki
  • View Affiliations / Copyright

    Affiliations: Department of Multidisciplinary Internal Medicine, Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori University, Yonago, Tottori 683‑8503, Japan, Department of Respiratory Medicine, Yonago Medical Center, Yonago, Tottori 683‑0006, Japan, Department of Brain and Neurosciences, Division of Neurology, Faculty of Medicine, Tottori University, Yonago, Tottori 683‑8503, Japan, Department of Pathology, Division of Pathology, Faculty of Medicine, Tottori University, Yonago, Tottori 683‑8503, Japan
    Copyright: © Inui et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 120
    |
    Published online on: June 1, 2022
       https://doi.org/10.3892/mco.2022.2553
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Abstract

Aseptic meningitis is a rare immune‑related adverse event (irAE), which occurs during treatment with immune checkpoint inhibitors (ICIs). This condition has non‑specific symptoms and exhibits no clear signs on magnetic resonance imaging (MRI). There are only a few reports of aseptic meningitis caused by pembrolizumab treatment for non‑small cell lung cancer (NSCLC). The present study includes a report of such a case and a review of the related literature. A 67‑year‑old Japanese man received first‑line pembrolizumab treatment for NSCLC and subsequently developed severe nausea and vomiting. No significant findings were observed following a computed tomography (CT) scan, MRI of the brain and upper gastrointestinal tract, or upper gastrointestinal endoscopy. Cerebrospinal fluid analysis revealed lymphocyte infiltration and elevation of the IgG index, without indications of metastasis or infection, which suggested the presence of aseptic meningitis. The symptoms immediately improved following prednisolone treatment, and aseptic meningitis was diagnosed as an irAE related to pembrolizumab treatment. Given that aseptic meningitis can cause non‑specific symptoms, including headache and nausea, the possibility of an irAE should be considered in patients with non‑specific symptoms who are receiving ICIs, and a cerebrospinal fluid examination should be performed.
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Copy and paste a formatted citation
Spandidos Publications style
Inui G, Funaki Y, Makino H, Touge H, Arai K, Kuroda K, Hirayama Y, Kato R, Nonaka T, Yamane K, Yamane K, et al: Pembrolizumab‑induced aseptic meningitis in a patient with non‑small cell lung cancer: A case report and literature review of aseptic meningitis as an immune‑related adverse event. Mol Clin Oncol 17: 120, 2022.
APA
Inui, G., Funaki, Y., Makino, H., Touge, H., Arai, K., Kuroda, K. ... Yamasaki, A. (2022). Pembrolizumab‑induced aseptic meningitis in a patient with non‑small cell lung cancer: A case report and literature review of aseptic meningitis as an immune‑related adverse event. Molecular and Clinical Oncology, 17, 120. https://doi.org/10.3892/mco.2022.2553
MLA
Inui, G., Funaki, Y., Makino, H., Touge, H., Arai, K., Kuroda, K., Hirayama, Y., Kato, R., Nonaka, T., Yamane, K., Teruya, Y., Sueda, Y., Sakamoto, T., Yamaguchi, K., Kodani, M., Kawase, S., Umekita, Y., Horie, Y., Nosaka, K., Yamasaki, A."Pembrolizumab‑induced aseptic meningitis in a patient with non‑small cell lung cancer: A case report and literature review of aseptic meningitis as an immune‑related adverse event". Molecular and Clinical Oncology 17.1 (2022): 120.
Chicago
Inui, G., Funaki, Y., Makino, H., Touge, H., Arai, K., Kuroda, K., Hirayama, Y., Kato, R., Nonaka, T., Yamane, K., Teruya, Y., Sueda, Y., Sakamoto, T., Yamaguchi, K., Kodani, M., Kawase, S., Umekita, Y., Horie, Y., Nosaka, K., Yamasaki, A."Pembrolizumab‑induced aseptic meningitis in a patient with non‑small cell lung cancer: A case report and literature review of aseptic meningitis as an immune‑related adverse event". Molecular and Clinical Oncology 17, no. 1 (2022): 120. https://doi.org/10.3892/mco.2022.2553
Copy and paste a formatted citation
x
Spandidos Publications style
Inui G, Funaki Y, Makino H, Touge H, Arai K, Kuroda K, Hirayama Y, Kato R, Nonaka T, Yamane K, Yamane K, et al: Pembrolizumab‑induced aseptic meningitis in a patient with non‑small cell lung cancer: A case report and literature review of aseptic meningitis as an immune‑related adverse event. Mol Clin Oncol 17: 120, 2022.
APA
Inui, G., Funaki, Y., Makino, H., Touge, H., Arai, K., Kuroda, K. ... Yamasaki, A. (2022). Pembrolizumab‑induced aseptic meningitis in a patient with non‑small cell lung cancer: A case report and literature review of aseptic meningitis as an immune‑related adverse event. Molecular and Clinical Oncology, 17, 120. https://doi.org/10.3892/mco.2022.2553
MLA
Inui, G., Funaki, Y., Makino, H., Touge, H., Arai, K., Kuroda, K., Hirayama, Y., Kato, R., Nonaka, T., Yamane, K., Teruya, Y., Sueda, Y., Sakamoto, T., Yamaguchi, K., Kodani, M., Kawase, S., Umekita, Y., Horie, Y., Nosaka, K., Yamasaki, A."Pembrolizumab‑induced aseptic meningitis in a patient with non‑small cell lung cancer: A case report and literature review of aseptic meningitis as an immune‑related adverse event". Molecular and Clinical Oncology 17.1 (2022): 120.
Chicago
Inui, G., Funaki, Y., Makino, H., Touge, H., Arai, K., Kuroda, K., Hirayama, Y., Kato, R., Nonaka, T., Yamane, K., Teruya, Y., Sueda, Y., Sakamoto, T., Yamaguchi, K., Kodani, M., Kawase, S., Umekita, Y., Horie, Y., Nosaka, K., Yamasaki, A."Pembrolizumab‑induced aseptic meningitis in a patient with non‑small cell lung cancer: A case report and literature review of aseptic meningitis as an immune‑related adverse event". Molecular and Clinical Oncology 17, no. 1 (2022): 120. https://doi.org/10.3892/mco.2022.2553
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