Convexal subarachnoid haemorrhage in a patient under pembrolizumab-lenvatinib combination therapy

被引:0
|
作者
Simao, Paulo [1 ,2 ]
Almeida, Marco Jose [3 ]
Catela, Joao [4 ]
Matias, Fernando [3 ]
机构
[1] Ctr Hosp & Univ Coimbra EPE, Internal Med, Campus Hosp Univ Coimbra, Coimbra, Portugal
[2] Ctr Hosp & Univ Cova Beira EPE, Internal Med, Covilha, Portugal
[3] Ctr Hosp & Univ Coimbra EPE, Neurol, Campus Hosp & Univ Coimbra, Coimbra, Portugal
[4] Ctr Hosp & Univ Coimbra EPE, Neurosurg, Coimbra, Portugal
关键词
Epilepsy and seizures; Neuroimaging; Non-vascular; Gynecological cancer; Unwanted effects / adverse reactions; CELL LUNG-CANCER; MELANOMA;
D O I
10.1136/bcr-2023-256100
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A woman in her 60s was brought to the emergency department due to a new-onset seizure. She was drowsy on arrival and unable to provide a clinical history. She had a medical history of advanced endometrial cancer, for which she was under the therapeutic protocol pembrolizumab plus lenvatinib. Laboratorial investigations were unremarkable. The brain CT angiography provided further insight into the case by detecting a bilateral convexal subarachnoid haemorrhage with discrete bilateral opercular vasogenic oedema, without other noticeable structural changes. Cerebrospinal fluid analysis was macroscopically haemorrhagic, but otherwise unremarkable. The brain MRI did not provide additional information. Although considered a rare adverse reaction, cerebral haemorrhage has been described for both pembrolizumab and lenvatinib. We cautiously assumed a probable drug aetiology after a thorough review of potential causes. Following discontinuation of these drugs and under anti-convulsive therapy, the patient remained asymptomatic and was discharged home.
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页数:3
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