Case Report: immune checkpoint inhibitor-associated aseptic meningitis in lung cancer: two cases illustrating an exclusion-based diagnosis approach and stepwise immunosuppressive treatment - Report - MDSpire
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Case Report: immune checkpoint inhibitor-associated aseptic meningitis in lung cancer: two cases illustrating an exclusion-based diagnosis approach and stepwise immunosuppressive treatment
Clinical Report: Aseptic Meningitis Linked to Immune Checkpoint Inhibitors
Background
Aseptic meningitis is a rare but serious immune-related adverse event associated with immune checkpoint inhibitors (ICIs). Early recognition and appropriate management are crucial to prevent significant morbidity. The overlap of symptoms with infectious meningitis complicates timely diagnosis and treatment.
Data Highlights
No numerical data or trial data provided in the source material.
Key Findings
Case 1 involved a 66-year-old woman who improved with high-dose intravenous methylprednisolone after exclusion of alternative diagnoses.
Case 2 involved a 75-year-old man who required tocilizumab as rescue therapy after high-dose corticosteroids failed to improve his condition.
Cerebrospinal fluid (CSF) analysis showed pleocytosis and marked protein elevation in both cases.
CSF multiplex polymerase chain reaction may assist in excluding common infections early in the diagnostic process.
High-dose corticosteroids are the cornerstone of initial therapy for suspected ICI-associated aseptic meningitis.
Clinical Implications
Clinicians should maintain a high index of suspicion for aseptic meningitis in patients receiving ICIs and promptly exclude other causes. Early initiation of immunosuppressive therapy is critical to improve patient outcomes.
Conclusion
These cases underscore the necessity of a structured diagnostic approach and timely management of ICI-associated aseptic meningitis to mitigate potential morbidity.
