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Case Reports
. 2021 Apr 6;8(4):e993.
doi: 10.1212/NXI.0000000000000993. Print 2021 Jul.

Pembrolizumab-Associated CD8+ Vasculitic Mononeuritis Multiplex in a Patient With Mesothelioma

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Case Reports

Pembrolizumab-Associated CD8+ Vasculitic Mononeuritis Multiplex in a Patient With Mesothelioma

Michaela C Baldauf et al. Neurol Neuroimmunol Neuroinflamm. .
No abstract available

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Figures

Figure
Figure. Chronology of Patient's History, Sural Nerve Ultrasound and Histologic Findings
(A) Time course of the patient's history in months. (B) High-resolution nerve ultrasound (18 MHz, Philips Epiq Q5) of the right sural nerve showing fascicular swelling (arrows) and nerve enlargement (dotted circle, cross-sectional area 5 mm2, norm <2 mm2), vein (star). (C) Sural nerve biopsy revealed a small vessel vasculitis with fibroid necrotic changes (arrow) of the vessel wall and myelin sheath disintegration (arrow), hematoxylin and eosin staining. Scale bar; 50 μm. (D) Toluidine blue-stained semi-thin cross-sections of the epon-embedded nerve show signs of axonal degeneration and an inhomogeneous loss of nerve fibers among various nerve fascicles, the latter being a typical finding in vasculitic neuritis. Scale bar; 100 μm. (E) Immunohistochemistry (brown) for lymphocyte markers CD4, CD8, and CD20; CD68 (macrophages). Scale bar; 100 μm.

References

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