Open AccessMyasthenia gravis and myopathy after nivolumab treatment for non‐small cell lung carcinoma: A case report
Author(s) -
Kim JeSeong,
Nam TaiSeung,
Kim Jieun,
Kho BoGun,
Park CheolKyu,
Oh InJae,
Kim YoungChul
Publication year - 2019
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.13177
Subject(s) - medicine , myasthenia gravis , nivolumab , pyridostigmine , ptosis , myopathy , ocular myasthenia , lung cancer , discontinuation , muscle biopsy , gastroenterology , immunotherapy , surgery , biopsy , cancer
Here, we report a case of myasthenia gravis and myopathy in a patient treated with nivolumab. A 76‐year‐old man who had been treated with four doses of nivolumab because of non‐small cell lung cancer (NSCLC) presented with proximal‐dominant muscle weakness and fluctuating ptosis and diplopia. Serologic studies revealed increased levels of muscle enzymes including creatine phosphokinase (2934 U/L), and acetylcholine receptor antibody was positive (1.31 nmol/L). Following electrodiagnostic study, he was diagnosed with myasthenia gravis and active stage of myopathy. After discontinuation of nivolumab, he was treated with corticosteroids, intravenous immunoglobulin G, and pyridostigmine. The neuromuscular symptoms and serologic abnormalities of the patient markedly improved. Currently, he is taking oral steroids and pyridostigmine without further immunotherapy.