Atezolizumab
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Atezolizumab Bell’s palsy: case report
A 68-year-old woman developed Bell’s palsy during treatment with atezolizumab for metastatic disease [route and dosages not stated]. The woman, who had a history of chromogranin positive, synaptophysin positive, CK7 and TTF-1 positive, small cell carcinoma of the lung, presented to the emergency department with a 2h history of right-sided facial droop and numbness. She also had a history of smoking (50 packs/year). On further examination, she was diagnosed with metastatic disease and started receiving treatment with chemotherapy/immunotherapy comprising of carboplatin, etoposide and atezolizumab. She achieved a complete response, and subsequently, her treatment was continued with atezolizumab only. In February 2020, she was diagnosed with neovascularization of the retina with some associated retinal haemorrhage. Atezolizumab was temporarily withheld, and she was treated with bevacizumab. In March 2020, atezolizumab was restarted. Two weeks prior to arrival at the emergency department, she received 5 cycles of atezolizumab. On arrival, she was alert and oriented with left-sided facial weakness and numbness, involving the forehead. She was not able to raise her left eyebrow or generate wrinkles on the left side of the forehead. Also, she was unable to close her left eye, along with drooping of the corner of the mouth with loss of the left nasolabial fold. Infectious aetiologies were found to be negative, and her vitamin-D level was low. The possibility of thrombotic occlusion was ruled out. She was hospitalised due to her history of malignancy. Various examinations were performed at hospital; however, all were found to be unremarkable. Therefore, based on her overall clinical conditions, she was diagnosed with Bell’s palsy. The woman’s immunotherapy with atezolizumab was temporarily withheld. She was treated with 14 day tapering course of prednisone, along with supportive measures as eye patch and artificial tears. After 4 weeks, her symptoms were completely resolved. Thereafter, the woman was re-started on maintenance therapy with atezolizumab without any complications. Kichloo A, et al. Atezolizumab-Induced Bell’s Palsy in a Patient With Small Cell Lung Cancer. Journal of Investigative Medicine High Impact Case Reports 8: 2020. Available from: URL: http://doi.org/10.1177/2324709620965010
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Reactions 21 Nov 2020 No. 1831
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