Immune checkpoint inhibitors have transformed the treatment of advanced malignancy, while increasing the risk of immune-related adverse events. A 56-year-old woman who had received nivolumab for stage 4 renal cell carcinoma subsequently developed altered behaviour, memory deficits and worsening of previously stable epilepsy. MR scan of the brain showed bilateral FLAIR (fluid-attenuated inversion recovery) hyperintensity of the mesial temporal lobes, and there were anti-Ma2 antibodies in both serum and cerebrospinal fluid. She was treated with corticosteroids but developed further clinical relapses requiring immunoglobulin and rituximab. The immune-related adverse events relating to immune checkpoint inhibitors are an emerging challenge for the neurologist. Some cases are refractory and require serial immunosuppression.

中文翻译：

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与 Ma2 抗体和免疫检查点抑制剂治疗相关的自身免疫性脑炎

免疫检查点抑制剂改变了晚期恶性肿瘤的治疗，同时增加了免疫相关不良事件的风险。一名 56 岁女性曾因 4 期肾细胞癌接受纳武单抗治疗，随后出现行为改变、记忆障碍和先前稳定的癫痫症状恶化。脑部 MR 扫描显示双侧颞叶内侧 FLAIR（液体衰减反转恢复）高信号，血清和脑脊液中均存在抗 Ma2 抗体。她接受了皮质类固醇治疗，但出现了需要免疫球蛋白和利妥昔单抗的进一步临床复发。与免疫检查点抑制剂相关的免疫相关不良事件是神经科医生面临的新挑战。有些病例是难治的，需要连续免疫抑制。