Guillain-Barre Syndrome in a patient with uterine adenocarcinoma undergoing treatment with immune-checkpoint inhibitor therapy: A case report and review of the literature

• Published in: Gynecologic oncology reports 2021-05, Vol.36, p.100739, Article 100739
• Main Authors: Brzezinska, Bogna N., Higgins, Robert V., Rungruang, Bunja
• Format: Article
• Language: English
• Subjects: Case Report; Guillain-Barre Syndrome; Immune-related adverse events; Immunotherapy; Pembrolizumab
• ISSN: 2352-5789; 2352-5789
• DOI: 10.1016/j.gore.2021.100739

•Use of immune checkpoint inhibitors in treatment of gynecologic malignancies is increasing.•Immune checkpoint inhibitors such as pembrolizumab may cause a variety of immune-related adverse effects.•Guillain-Barre Syndrome is a rare but potentially fatal adverse effect that requires prompt evaluation and treatment. Use of immune checkpoint inhibitors in treatment of gynecologic malignancies is increasing. Rare, but potentially fatal, immune-related neurologic adverse events may occur as a result of treatment. A 72 year old female with recurrent metastatic uterine adenocarcinoma received pembrolizumab and lenvatinib combination therapy. Following her second dose of pembrolizumab, the patient developed multiple neurologic symptoms. She was ultimately diagnosed with Guillain-Barre Syndrome based on neurologic evaluation with imaging, serum studies, and cerebrospinal fluid analysis. The patient was successfully treated with high-dose intravenous corticosteroids and intravenous immunoglobulin. Neurologic complications related to immune checkpoint inhibitor therapy are rare. It is imperative for gynecologic oncologists to be familiar with potentially fatal hazards of therapy to allow for rapid diagnosis and treatment.