You are here

  • Home
  • Archive
  • Volume 17, Issue 11
  • Severe subacute onset sensorimotor polyneuropathy associated with brentuximab vedotin treatment for refractory classical Hodgkin’s lymphoma

Article Text

Article menu
Download PDFPDF
Neurology
Severe subacute onset sensorimotor polyneuropathy associated with brentuximab vedotin treatment for refractory classical Hodgkin’s lymphoma
  1. Nuala McNicholas1,
  2. Hwai Jing Hiew2,
  3. Ramamurthy Arunachalam1 and
  4. Chinar Osman1
  1. 1Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
  2. 2Department of Haematology, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
  1. Correspondence to Dr Nuala McNicholas; nonniemcnicholas{at}hotmail.com

Abstract

A man in his 30s with a history of refractory classical Hodgkin’s lymphoma presented with subacute onset asymmetric sensory disturbance, and severe weakness affecting his right more than left hand. Symptom onset was 18 weeks after commencing brentuximab vedotin (BV) treatment, an anti-CD30 antibody drug-conjugate for relapsed/refractory classical Hodgkin’s lymphoma. Symptoms progressed to his lower limbs with distal sensory loss, gait imbalance, bilateral foot drop and mild proximal leg weakness. He was globally areflexic. Neurophysiology revealed a mildly asymmetric, non-length dependent, motor >sensory polyradiculoneuropathy, with mixed axonal and demyelinating features. Extensive laboratory work-up, lumbar puncture and MRI of the brachial plexus, brain, spine and chest were unremarkable. Treatment with plasma exchange, followed by intravenous immunoglobulin, resulted in objective clinical improvement 4 weeks after. BV is a potent antimicrotubule agent, thus well known to cause a length-dependent sensory axonal polyneuropathy. Demyelinating polyneuropathy, with more prominent motor involvement, in association with BV is much rarer.

  • Clinical neurophysiology
  • Peripheral nerve disease

https://doi.org/10.1136/bcr-2024-262139

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: NM is the guarantor and corresponding author. The following authors gave final approval of the manuscript: NM, HJH, RA, CO.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests CO has received a speaker fee on plasma exchange from Terumo BCT. NM, HJH and RA have no conflicts of interest to declare.

    • Provenance and peer review Not commissioned; externally peer-reviewed.