Data_Sheet_1_Acupuncture Treatment of Guillain–Barré Syndrome After Using Immune Checkpoint Inhibitors: A Case Report.pdf

Guillain–Barré syndrome(GBS) is an autoimmune-mediated peripheral neuropathy. Immune checkpoint inhibitors (ICIs) are the standard treatment for cancer and may lead to immune-related adverse events (irAEs) such as GBS. Corticosteroids, plasma exchange (PE), and intravenous immunoglobulin (IVIG) are currently accepted treatments for ICI-induced GBS. However, there are still adverse reactions, and the effect of relieving symptoms is not as good as expected. Safe and effective complementary replacement therapy to alleviate GBS symptoms and ameliorate the quality of life is urgently required. In this case, a 63-year-old man received ICI therapy and antitumor chemotherapy for lung malignancy. After two courses of treatment, the patient gradually developed limb weakness, numbness, and pain at the ends of the limbs, with cerebrospinal fluid (CSF) albuminocytological dissociation, and electromyography (EMG) suggested demyelinating changes and was diagnosed as GBS. Although the patient received high doses of intravenous gamma globulin and limb weakness symptoms were alleviated, there was still significant numbness and pain in the extremities. After four times of acupuncture treatments, the patient complained that the symptoms of limb numbness and fatigue were significantly alleviated without any discomfort. This case report may provide a new alternative and complementary therapy for immune checkpoint inhibitor-induced GBS, but more definitive and robust evidence is needed to support its efficacy.

吉兰-巴雷综合征（Guillain–Barré syndrome，简称 GBS）是一种由自身免疫介导的外周神经病变。免疫检查点抑制剂（Immune checkpoint inhibitors，简称 ICIs）是癌症的标准治疗方法，但可能导致免疫相关不良事件（immune-related adverse events，简称 irAEs），例如 GBS。目前，皮质类固醇、血浆置换（plasma exchange，简称 PE）和静脉注射免疫球蛋白（intravenous immunoglobulin，简称 IVIG）被普遍接受为 ICIs 诱导的 GBS 的治疗方法。然而，仍存在不良反应，且缓解症状的效果不如预期。迫切需要一种安全有效的辅助替代疗法，以缓解 GBS 症状并改善生活质量。在此案例中，一名 63 岁男性因肺癌接受了 ICIs 疗法和抗肿瘤化疗。经过两疗程的治疗后，患者逐渐出现肢体无力、末端麻木和疼痛，伴有脑脊液（cerebrospinal fluid，简称 CSF）蛋白细胞分离现象，电肌图（electromyography，简称 EMG）提示脱髓鞘改变，并被诊断为 GBS。尽管患者接受了高剂量静脉注射免疫球蛋白，肢体无力症状有所缓解，但四肢仍然存在显著的麻木和疼痛。经过四次针灸治疗后，患者反映肢体麻木和疲劳症状显著缓解，且未出现任何不适。此病例报告可能为免疫检查点抑制剂诱导的 GBS 提供一种新的替代和辅助治疗方法，但需要更多确凿且强有力的证据来支持其疗效。