Demyelination of the central nervous system and peripheral neuropathy associated with sintilimab treatment for lung adenocarcinoma: a case report.
7 affiliations
- 1Department of Respiratory and Critical Care Medicine, The People's Hospital of Leshan, Leshan, 614000, Sichuan, People's Republic of China.
- 2Department of Respiratory and Critical Care Medicine, The People's Hospital of Jianyang, Jianyang, 641400, Sichuan, People's Republic of China.
- 3Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China.
- 4Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China. [email protected].
- 5Department of Critical Care Medicine, Sichuan Cancer Hospital, Chengdu, 610041, Sichuan, People's Republic of China. [email protected].
- 6Department of Respiratory and Critical Care Medicine, The People's Hospital of Leshan, Leshan, 614000, Sichuan, People's Republic of China. [email protected].
- 7Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China. [email protected].
Abstract
Background
Immune checkpoint inhibitor (ICI) therapy unleashes the body's natural immune system to fight cancer. Neurological immune-related adverse events (NirAEs) are rare but can be severe.Case presentation
In this report, we present a 47-year-old man of Han ethnicity who was diagnosed with lung adenocarcinoma with intracranial metastasis. Initially, the patient underwent intracranial radiotherapy followed by first-line and maintenance chemotherapy with pemetrexed, cisplatin and bevacizumab, and a partial response was achieved without significant toxicity. After progression, the patient received second-line chemotherapy with carboplatin and albumin-bound paclitaxel as well as an ICI, sintilimab, every 28 days. After completing nine cycles of sintilimab therapy, the patient suddenly experienced lower limb paresthesia, weakness and temporary confusion. Findings from diagnostic studies, including laboratory, electrophysiological and imaging studies, combined with the clinical presentation led to the diagnosis of NirAEs, including peripheral neuropathy and demyelination of the central nervous system. Sintilimab therapy was suspended, and intravenous corticosteroid therapy was initiated, resulting in a temporary rapid resolution of all neuropathic symptoms. However, the patient died within one month after the onset of neuropathic symptoms.Conclusion
This extremely rare case of NirAEs affecting both the peripheral and central nervous systems had the worst prognosis.
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BibTeX
@article{deng2026demyelination,
title = {{Demyelination of the central nervous system and peripheral neuropathy associated with sintilimab treatment for lung adenocarcinoma: a case report.}},
author = {Haibo Deng and Yu He and Hailong Wei and Qun Yi and Wei Luo},
journal = {Journal of medical case reports},
year = {2026},
month = jul,
doi = {10.1186/s13256-026-06402-3},
url = {https://europepmc.org/article/MED/42894252},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Demyelination of the central nervous system and peripheral neuropathy associated with sintilimab treatment for lung adenocarcinoma: a case report.
AU - Haibo Deng
AU - Yu He
AU - Hailong Wei
AU - Qun Yi
AU - Wei Luo
PY - 2026
DA - 2026/07/01
JO - Journal of medical case reports
DO - 10.1186/s13256-026-06402-3
UR - https://europepmc.org/article/MED/42894252
AB - Background Immune checkpoint inhibitor (ICI) therapy unleashes the body's natural immune system to fight cancer. Neurological immune-related adverse events (NirAEs) are rare but can be severe.Case presentation In this report, we present a 47-year-old man of Han ethnicity who was diagnosed with lung adenocarcinoma with intracranial metastasis. Initially, the patient underwent intracranial radiotherapy followed by first-line and maintenance chemotherapy with pemetrexed, cisplatin and bevacizumab, and a partial response was achieved without significant toxicity. After progression, the patient received second-line chemotherapy with carboplatin and albumin-bound paclitaxel as well as an ICI, sintilimab, every 28 days. After completing nine cycles of sintilimab therapy, the patient suddenly experienced lower limb paresthesia, weakness and temporary confusion. Findings from diagnostic studies, including laboratory, electrophysiological and imaging studies, combined with the clinical presentation led to the diagnosis of NirAEs, including peripheral neuropathy and demyelination of the central nervous system. Sintilimab therapy was suspended, and intravenous corticosteroid therapy was initiated, resulting in a temporary rapid resolution of all neuropathic symptoms. However, the patient died within one month after the onset of neuropathic symptoms.Conclusion This extremely rare case of NirAEs affecting both the peripheral and central nervous systems had the worst prognosis.
SN - 1752-1947
ER -