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Washington University Experience | PERIPHERAL NEUROPATHY | 15 NEUROPATHY ASSOCIATED WITH NEOPLASIA | 2 Paraneoplastic Neuropathy | 5A0 Case 5 History
Case 5 History ---- The patient is a 31-year-old man with a history of stage III melanoma status post wide excision, lymphadenectomy and treatment with ipilimumab, which is a monoclonal antibody that works by blocking CTLA-4 on T cells. The patient received his fourth treatment of ipilimumab in the week prior to admission in November 2010 for dizziness followed by diplopia. His symptoms progressed to facial weakness, bilateral lower extremity pain and mild dysphagia. Clinical impression: Paraneoplastic neuropathy versus adverse reaction to ipilimumab (including symptoms similar to Guillain-Barre syndrome). Operative procedure: Right sural nerve biopsy. I am showing this case in order to demonstrate that a firm diagnosis of paraneoplastic neuropathy may be complicated by concurrent therapy, especially with new agents whose complications may be incompletely established.
