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Antibody-Negative Nivolumab-Induced Autoimmune Encephalitis: A Case Report and Review of Seronegative Presentations.

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Cureus 📖 저널 OA 99.9% 2021: 42/43 OA 2022: 79/79 OA 2023: 181/181 OA 2024: 284/284 OA 2025: 774/774 OA 2026: 506/506 OA 2021~2026 2026 Vol.18(2) p. e102834 OA
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Hamza M, Randolph H, Thebault S

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Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but can provoke immune-related neurological complications, including autoimmune encephalitis (AIE).

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APA Hamza M, Randolph H, Thebault S (2026). Antibody-Negative Nivolumab-Induced Autoimmune Encephalitis: A Case Report and Review of Seronegative Presentations.. Cureus, 18(2), e102834. https://doi.org/10.7759/cureus.102834
MLA Hamza M, et al.. "Antibody-Negative Nivolumab-Induced Autoimmune Encephalitis: A Case Report and Review of Seronegative Presentations.." Cureus, vol. 18, no. 2, 2026, pp. e102834.
PMID 41788085 ↗

Abstract

Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but can provoke immune-related neurological complications, including autoimmune encephalitis (AIE). We report a 70-year-old woman who developed AIE after 11 months of adjuvant nivolumab for melanoma. Serial cerebrospinal fluid (CSF) studies revealed a lymphocytic pleocytosis and elevated protein that improved with corticosteroids, intravenous immunoglobulin (IVIG), and rituximab. Magnetic resonance imaging (MRI) showed evolving bilateral thalamic and periventricular T2/FLAIR (fluid-attenuated inversion recovery) hyperintensities. CSF and serum were negative for paraneoplastic and antineuronal antibodies. Altogether, this case illustrates a late-onset, antibody-negative form of ICI-associated AIE. We also provide a focused review of ICI-associated seronegative AIE presentations, including epidemiology, clinical features, diagnostic approach, management, and prognosis. This report underscores the need for sustained vigilance for AIE throughout the course of ICI therapy and highlights serial CSF cell counts as a useful biomarker for diagnostic support and treatment monitoring.

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