Case Report: immune checkpoint inhibitor-associated aseptic meningitis in lung cancer: two cases illustrating an exclusion-based diagnosis approach and stepwise immunosuppressive treatment - Scorecard - MDSpire

Case Report: immune checkpoint inhibitor-associated aseptic meningitis in lung cancer: two cases illustrating an exclusion-based diagnosis approach and stepwise immunosuppressive treatment

  • By

  • Hiroshi Nakahama

  • Shigeo Hanada

  • Eisuke Takeda

  • Yui Takahashi

  • Yuichiro Nei

  • Takahiro Mitsumura

  • Atsushi Miyamoto

  • Meiyo Tamaoka

  • July 7, 2026

  • 0 min

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Clinical Scorecard: Clinical Insights: Aseptic Meningitis Linked to Immune Checkpoint Inhibitors in Lung Cancer - Two Cases Demonstrating Diagnostic Exclusion and Gradual Immunosuppressive Management

At a Glance

CategoryDetail
ConditionAseptic Meningitis
Key MechanismsImmune checkpoint inhibitor-associated neurological immune-related adverse event
Target PopulationPatients with lung adenocarcinoma receiving immune checkpoint inhibitors
Care SettingOncology and neurology clinical settings

Key Highlights

  • Aseptic meningitis can occur after initiation of immune checkpoint inhibitors.
  • Timely exclusion of infectious causes is critical for appropriate management.
  • High-dose corticosteroids are the cornerstone of initial therapy.
  • CSF multiplex PCR may aid in excluding treatable infections.
  • Stepwise immunosuppressive treatment may be necessary in refractory cases.

Guideline-Based Recommendations

Diagnosis

  • Perform neuroimaging and CSF analysis to exclude alternative diagnoses.
  • Consider CSF multiplex PCR to rule out common infections.

Management

  • Initiate high-dose intravenous corticosteroids for suspected ICI-associated aseptic meningitis.

Monitoring & Follow-up

  • Monitor neurological status and CSF parameters for treatment response.

Risks

  • Delayed diagnosis and treatment can lead to substantial morbidity.

Patient & Prescribing Data

Patients with lung adenocarcinoma treated with immune checkpoint inhibitors.

Immunosuppressive therapy should be escalated based on clinical response.

Clinical Best Practices

  • Rapidly exclude infectious meningitis and leptomeningeal carcinomatosis.
  • Tailor treatment escalation according to clinical response.

Related Resources & Content

Original Source(s)

Case Report: immune checkpoint inhibitor-associated aseptic meningitis in lung cancer: two cases illustrating an exclusion-based diagnosis approach and stepwise immunosuppressive treatment

  • by Hiroshi Nakahama, Shigeo Hanada, Eisuke Takeda, Yui Takahashi, Yuichiro Nei, Takahiro Mitsumura, Atsushi Miyamoto, Meiyo Tamaoka

  • July 7, 2026

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