Severe Relapse of Vaccine-Induced Guillain-Barré Syndrome After Treatment With Nivolumab

J Clin Neuromuscul Dis. 2019 Jun;20(4):194-199. doi: 10.1097/CND.0000000000000230.


Cancer immunotherapy with checkpoint inhibitors may result in neuromuscular immune-related adverse reactions, including Guillain-Barré syndrome (GBS)-like disease. On the other hand, checkpoint inhibitor therapy may result in exacerbation of underlying autoimmune diseases such as myasthenia gravis and multiple sclerosis. We present a patient who developed a severe and fatal relapse of postvaccination GBS after he was treated with nivolumab, a monoclonal antibody directed to programmed death-1 (PD-1), during a GBS treatment-related fluctuation. We recommend that caution be exercised in starting treatment with PD-1 inhibitors in the acute stage or early in the recovery period of GBS.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Guillain-Barre Syndrome / drug therapy*
  • Guillain-Barre Syndrome / etiology
  • Humans
  • Influenza Vaccines / adverse effects*
  • Male
  • Nivolumab / adverse effects
  • Nivolumab / therapeutic use*
  • Recurrence


  • Influenza Vaccines
  • Nivolumab