A 63-year-old woman presented with bilateral lower extremity weakness, Lhermitte sign, and urinary retention over a 3-week period. She had a 35–pack-year smoking history and was diagnosed as having stage IV small-cell lung cancer with lymphatic and liver metastases. She had been treated with 3 cycles of etoposide and carboplatin (3 daily doses per cycle) and atezolizumab (humanized monoclonal IgG1 antibody against programmed cell death ligand 1 [PDL1]; 1 dose per cycle).
Examination demonstrated bilateral finger extensor weakness, lower limb pyramidal weakness greater on the right side, bilateral Babinski signs, reduced vibration, joint position sense, and a midchest pin-prick sensory level. At the nadir, she required a wheelchair and self-catheterization.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Kunchok A, Zekeridou A, Pittock S. CRMP5-IgG–Associated Paraneoplastic Myelopathy With PD-L1 Inhibitor Therapy. JAMA Neurol. 2020;77(2):255–256. doi:10.1001/jamaneurol.2019.4379
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: