Immune checkpoint inhibitors (ICIs) have improved the overall survival of many patients with advanced cancers. However, unlike cytotoxic and targeted drugs, ICIs may cause various immune-related adverse events (irAEs). Among these irAEs, autoimmune meningitis is very rare. Here, we report a case of early-onset, atezolizumab-induced meningitis after administration of one dose of atezolizumab. A 56-year-old man with lung adenocarcinoma had received seventh-line treatment with atezolizumab when he experienced dysarthria. Blood examinations, including the measurement of electrolytes, glucose, and organ functions, were unremarkable, but enhanced head magnetic resonance imaging T1-weighted images showed meningeal enhancement. Although cerebral spinal fluid (CSF) examinations revealed elevated lymphocyte and protein levels, no cancer cells were detected in the CSF. CSF cultures and serological tests, including polymerase chain reaction for herpes simplex virus, were negative. The patient was therefore diagnosed with atezolizumab-triggered autoimmune meningitis. With steroid treatment, the patient's clinical and neurological state improved immediately and he recovered to baseline conditions. Prompt diagnosis and therapeutic intervention are essential for the effective treatment of autoimmune meningitis.

中文翻译：

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与 atezolizumab 治疗非小细胞肺癌相关的早发性脑膜炎：病例报告和文献复习。

免疫检查点抑制剂 (ICI) 改善了许多晚期癌症患者的总生存期。然而，与细胞毒性药物和靶向药物不同，ICI 可能会引起各种免疫相关不良事件 (irAE)。在这些 irAE 中，自身免疫性脑膜炎非常罕见。在这里，我们报告了一例阿特朱单抗给药后早发性阿特朱单抗诱发的脑膜炎病例。一名患有肺腺癌的 56 岁男性在出现构音障碍时接受了 atezolizumab 的七线治疗。包括电解质、葡萄糖和器官功能测量在内的血液检查无异常，但增强的头部磁共振成像 T1 加权图像显示脑膜增强。尽管脑脊髓液 (CSF) 检查显示淋巴细胞和蛋白质水平升高，脑脊液中未检测到癌细胞。脑脊液培养和血清学检测（包括单纯疱疹病毒聚合酶链反应）均为阴性。因此，患者被诊断为阿替利珠单抗引发的自身免疫性脑膜炎。通过类固醇治疗，患者的临床和神经状态立即得到改善，恢复到基线状态。及时诊断和治疗干预对于有效治疗自身免疫性脑膜炎至关重要。