Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Atezolizumab-induced Encephalitis in a Patient with Hepatocellular Carcinoma: A Case Report and Literature Review
Tomoyuki SatakeYuta MarukiYuko KuboMasamichi TakahashiAkihiro OhbaYoshikuni NagashioShunsuke KondoSusumu HijiokaChigusa MorizaneHideki UenoTakuji Okusaka
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JOURNAL OPEN ACCESS

2022 Volume 61 Issue 17 Pages 2619-2623

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Abstract

We herein report a case of encephalitis in a 42-year-old woman with hepatocellular carcinoma following atezolizumab plus bevacizumab therapy. After two weeks of treatment, she was admitted for a high fever, impaired consciousness, and convulsive seizure refractory to diazepam. Magnetic resonance imaging revealed a hyperintense splenial lesion. A cerebrospinal fluid test excluded malignancy and infection. These findings were highly suggestive of a diagnosis of encephalitis due to atezolizumab, an immune-related adverse event. Steroid pulse therapy improved the fever and seizure. However, her incomplete right-sided paralysis and aphasia persisted. This is the first case report of encephalitis caused by atezolizumab plus bevacizumab therapy for hepatocellular carcinoma.

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© 2022 by The Japanese Society of Internal Medicine
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