Optic neuritis in lung adenocarcinoma: A challenging diagnosis.

Authors :: Goudsmit A
Brandao M
Oullai A
Engelman D
Ghorra N
Daif T
Buelens T
Meert AP
Source :: Respiratory medicine and research [Respir Med Res] 2022 Nov; Vol. 82, pp. 100966. Date of Electronic Publication: 2022 Oct 17.
Publication Year :: 2022
Abstract: Optic neuritis with CRMP-5 IgG is a paraneoplastic inflammation of the optic nerve associated with lung cancer, mostly small-cell lung cancer. We present the case of a patient with lung adenocarcinoma who developed progressive bilateral visual loss a few months after immune-chemotherapy with pembrolizumab and after Covid-19 vaccination. Positive CRMP-5 IgG were detected in blood sample and complete work-up - including brain MRI - did not show any progression. High dose systemic corticoids were administered with transient improving, followed by intravenous immunoglobulins, methotrexate and rituximab but despite negativization of CRMP-5 IgG, the patient had a progressive visual loss.<br />Competing Interests: Conflicts of interest AG: no conflict of interest. MB: travel grant from Roche/GNE and Sanofi, speaker honorarium from Roche/GNE and Janssen (to my institution). AO: no conflict of interest. DE: no conflict of interest. TD: no conflict of interest. NG: no conflict of interest. TB: no conflict of interest. APM: grant from BMS outside the submitted work.<br /> (Copyright © 2022 SPLF and Elsevier Masson SAS. All rights reserved.)