Neuralgic Amyotrophy Following B-Cell Maturation Antigen-Directed CAR-T Therapy.
Eduardo J Pérez-Torres, Daria V Madeeva, Adam D Cohen et al.
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Case in brief
This report describes four patients who developed neuralgic amyotrophy following B-cell maturation antigen-directed CAR-T therapy, representing 1.5% of treated patients. Symptoms included acute bilateral shoulder pain and weakness occurring 8-12 days post-infusion, with electromyography revealing denervation in specific muscles. While corticosteroids were associated with symptomatic improvement, most patients experienced residual weakness. Delayed diagnosis occurred in three cases due to misattribution of symptoms.
Diagnostic / clinical pearl
Clinicians should be aware of neuralgic amyotrophy as a potential complication of BCMA-directed CAR-T therapy, characterized by bilateral shoulder pain and weakness occurring shortly after treatment.
Why it matters
Prompt recognition and treatment of this condition may reduce long-term neurological morbidity in patients undergoing CAR-T therapy.