title: More than a headache: a case of cetuximab-induced aseptic meningitis.
abstract: While the wide belief is that monoclonal antibodies, due to their large size, would not be able to penetrate the blood-brain barrier, we present a rare case of aseptic meningitis induced by intravenous cetuximab administration. A 58-year-old man with tonsillar squamous cell cancer presented with headache and fever, which started approximately 1 h after his first dose of cetuximab (loading dose of 400 mg/m(2) equalling 800 mg). CT scan of the head was non-revealing and laboratory tests including complete blood count, serum comprehensive metabolic panel and coagulation profile were within normal limits. Aseptic meningitis in the setting of cetuximab therapy has been reported on 6 previous occasions. Consistent with these prior reports, it is interesting to note that this case also occurred after administration of the initial higher loading dose of Cetuximab. This is of interest as Cetuximab is more frequently being dosed at 500 mg/m(2) (higher dose) every 2 weeks in colorectal cancer.
authors.affiliation: Department of Medicine, Jacobi Medical Center, Bronx, New York, USA.
authors.forename: Devika
authors.initials: D
authors.lastname: Prasanna
authors.affiliation: Department of Medicine-Oncology, Jacobi Medical Center, Bronx, New York, USA.
authors.forename: Tarek
authors.initials: T
authors.lastname: Elrafei
authors.affiliation: Department of Medicine-Oncology, Jacobi Medical Center, Bronx, New York, USA.
authors.forename: Elaine
authors.initials: E
authors.lastname: Shum
authors.affiliation: Department of Medicine-Oncology, Jacobi Medical Center, Bronx, New York, USA.
authors.forename: Marianna
authors.initials: M
authors.lastname: Strakhan
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D000068818:Cetuximab / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D005334:Fever / Q000209:etiology; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D014067:Tonsillar Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000068818:Cetuximab