Brentuximab Vedotin-Induced CIDP-Like Inflammatory Demyelinating Polyradiculoneuropathy (Clinical Case Report)

Abstract

Brentuximab vedotin-induced inflammatory demyelinating polyradiculoneuropathy is a rare chemotherapy side effect. The underlying cause of disease is thought to be pathological drug effects on the humoral immune system. The typical clinical picture is characterized by progressive development of flaccid tetraparesis and severe polyneuritic manifestations, which typically leads to disability and significant impairment in quality of life. Nerve conduction study results show evidence of generalized primary demyelination, including conduction block and sural sparing pattern.Clinical and anamnestic data and objective observational findings are similar to the clinical and neurophysiological pattern observed in acute or recurrent inflammatory demyelinating polyradiculoneuropathies. It is important to emphasize that brentuximab vedotin-induced inflammatory demyelinating polyradiculoneuropathy response to accepted in guidelines pathogenic therapy, which includes corticosteroids, intravenous human immunoglobulin therapy and extracorporeal hemocorrection methods. Clinicians should be aware of treatment possibilities due to reversibility of neurological impairment through the pathogenetic immunosuppressive therapy. This clinical case represents a case of brentuximab-induced inflammatory demyelinating polyradiculoneuropathy with progressive development of severe motor impairment, which led to complete immobilization over 6 months. This clinical case report demonstrates optimal management strategy: timely administration of pathogenetic therapy with appropriate dosing, slow and gradual reduction in corticosteroid dosage. Competent management strategy ensures favorable outcome of the curable druginduced polyradiculoneuropathy.