Background and Objectives: We present the case of a 67-year-old man who developed encephalopathy, headaches, and seizure activity after initiating treatment with the novel tyrosine kinase inhibitor, sitravatinib. Methods: The patient was identified in routine clinical practice. Results: Brain MRI revealed lobar microhemorrhages and bihemispheric vasogenic edema. The patient met the criteria for probable cerebral amyloid angiopathy-related inflammation (CAA-ri) and responded favorably to high-dose methylprednisolone. Discussion: This report of neurologic autoimmunity in a patient receiving sitravatinib opens new lines of inquiry into the pathophysiology of CAA-ri. We emphasize the importance of early recognition and treatment of CAA-ri among patients receiving immunomodulatory chemotherapy.
Background and Objectives: We present the case of a 67-year-old man who developed encephalopathy, headaches, and seizure activity after initiating treatment with the novel tyrosine kinase inhibitor, sitravatinib. Methods: The patient was identified in routine clinical practice. Results: Brain MRI revealed lobar microhemorrhages and bihemispheric vasogenic edema. The patient met the criteria for probable cerebral amyloid angiopathy-related inflammation (CAA-ri) and responded favorably to high-dose methylprednisolone. Discussion: This report of neurologic autoimmunity in a patient receiving sitravatinib opens new lines of inquiry into the pathophysiology of CAA-ri. We emphasize the importance of early recognition and treatment of CAA-ri among patients receiving immunomodulatory chemotherapy.
Authors: Eitan Auriel; Andreas Charidimou; M Edip Gurol; Jun Ni; Ellis S Van Etten; Sergi Martinez-Ramirez; Gregoire Boulouis; Fabrizio Piazza; Jacopo C DiFrancesco; Matthew P Frosch; Oct Vio M Pontes-Neto; Ashkan Shoamanesh; Yael Reijmer; Anastasia Vashkevich; Alison M Ayres; Kristin M Schwab; Anand Viswanathan; Steven M Greenberg Journal: JAMA Neurol Date: 2016-02 Impact factor: 18.302