A case of suspected autoimmune encephalitis after the introduction of atezolizumab + bevacizumab therapy for hepatocellular carcinoma

This is the case of a 68-year-old male. On the 14th day after the introduction of atezolizumab, an immune-checkpoint inhibitor (ICI) for hepatocellular carcinoma, the patient developed difficulty in moving and had chills. Since body temperature was 39.4°C, consciousness disorder developed on the 16th day, and steroid pulse therapy was started for possible encephalitis, which is an immune-related adverse event (irAE) caused by atezolizumab, steroid administration was continued because the patient's consciousness disorder improved, and no relapse of symptoms was observed. Listing irAEs as a differentiation of fever and impaired consciousness of unknown cause during ICI administration and starting treatment as soon as possible are important.