Atezolizumab

Myelopathy
A case report was published in 2020 of a patient who developed bilateral arm and leg weakness causing her to become wheelchair bound, and was found to have T2 hyperintensity in the lateral funiculi of the spinal cord with contrast enhancement, as well as edema from C5 to the midhotracic cord. CRMP5-IgG was detected in both the serum and CSF with a high titer. She was treated with methyprednisolone 1g daily for 3 days, then 1g weekly for 5 weeks, then 1g biweekly for 6 weeks. She was also treated with cyclophosphamide 2 mg/kg PO for 24 weeks, and by 24 weeks was able to ambulate with a cane. This case may have been due to atezolizumab exacerbating an underlying propensity for CRMP5-IgG, given that she had stage IV small cell lung CA, which is associated with CRMP5-IgG antibodies.