New onset of myasthenia gravis after intravesical Bacillus Calmette-Guerin

Tsubasa Takizawa, Marenori Kojima, Shigeaki Suzuki, Takashi Osada, Satoshi Kitagawa, Jin Nakahara, Shinichi Takahashi, Norihiro Suzuki

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Rationale: Recently, drug-related myasthenia gravis (MG) has received attention, because the number of reported cases involving MG associated with immune checkpoint inhibitors, a new immunotherapy, is increasing. We present a case involving the new onset of MG, in which the symptoms started shortly after intravesical Bacillus Calmette-Guerin (BCG) for bladder cancer. Patient concerns: A 69-year-old male with bladder cancer developed ptosis and diplopia 4 days after the completion of a treatment regimen with intravesical BCG weekly for 6 weeks. Diagnoses: Ocular MG was confirmed by a positive serum anti-acetylcholine receptor antibody test. Interventions: Treatment with high-dose methylprednisolone pulse therapy was given, after insufficient treatment with pyridostigmine bromide and 10 mg/d prednisolone. Outcomes: Symptoms resolved completely 12 days after high-dose methylprednisolone pulse therapy. Lessons: Intravesical BCG could be listed as a novel drug that may induce a new onset of MG along with drugs such as D-penicillamine and immune checkpoint inhibitors.

Original languageEnglish
Article numbere8757
JournalMedicine (United States)
Volume96
Issue number46
DOIs
Publication statusPublished - 2017 Nov 1

Fingerprint

Myasthenia Gravis
Mycobacterium bovis
Methylprednisolone
Urinary Bladder Neoplasms
Pharmaceutical Preparations
Pyridostigmine Bromide
Therapeutics
Penicillamine
Diplopia
Cholinergic Receptors
Prednisolone
Immunotherapy
Antibodies
Serum

Keywords

  • Bladder cancer
  • Drug-related
  • Intravesical Bacillus Calmette-Guerin
  • Myasthenia gravis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

New onset of myasthenia gravis after intravesical Bacillus Calmette-Guerin. / Takizawa, Tsubasa; Kojima, Marenori; Suzuki, Shigeaki; Osada, Takashi; Kitagawa, Satoshi; Nakahara, Jin; Takahashi, Shinichi; Suzuki, Norihiro.

In: Medicine (United States), Vol. 96, No. 46, e8757, 01.11.2017.

Research output: Contribution to journalReview article

Takizawa, Tsubasa ; Kojima, Marenori ; Suzuki, Shigeaki ; Osada, Takashi ; Kitagawa, Satoshi ; Nakahara, Jin ; Takahashi, Shinichi ; Suzuki, Norihiro. / New onset of myasthenia gravis after intravesical Bacillus Calmette-Guerin. In: Medicine (United States). 2017 ; Vol. 96, No. 46.
@article{dbc18b91b43449388e726797599389dd,
title = "New onset of myasthenia gravis after intravesical Bacillus Calmette-Guerin",
abstract = "Rationale: Recently, drug-related myasthenia gravis (MG) has received attention, because the number of reported cases involving MG associated with immune checkpoint inhibitors, a new immunotherapy, is increasing. We present a case involving the new onset of MG, in which the symptoms started shortly after intravesical Bacillus Calmette-Guerin (BCG) for bladder cancer. Patient concerns: A 69-year-old male with bladder cancer developed ptosis and diplopia 4 days after the completion of a treatment regimen with intravesical BCG weekly for 6 weeks. Diagnoses: Ocular MG was confirmed by a positive serum anti-acetylcholine receptor antibody test. Interventions: Treatment with high-dose methylprednisolone pulse therapy was given, after insufficient treatment with pyridostigmine bromide and 10 mg/d prednisolone. Outcomes: Symptoms resolved completely 12 days after high-dose methylprednisolone pulse therapy. Lessons: Intravesical BCG could be listed as a novel drug that may induce a new onset of MG along with drugs such as D-penicillamine and immune checkpoint inhibitors.",
keywords = "Bladder cancer, Drug-related, Intravesical Bacillus Calmette-Guerin, Myasthenia gravis",
author = "Tsubasa Takizawa and Marenori Kojima and Shigeaki Suzuki and Takashi Osada and Satoshi Kitagawa and Jin Nakahara and Shinichi Takahashi and Norihiro Suzuki",
year = "2017",
month = "11",
day = "1",
doi = "10.1097/MD.0000000000008757",
language = "English",
volume = "96",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "46",

}

TY - JOUR

T1 - New onset of myasthenia gravis after intravesical Bacillus Calmette-Guerin

AU - Takizawa, Tsubasa

AU - Kojima, Marenori

AU - Suzuki, Shigeaki

AU - Osada, Takashi

AU - Kitagawa, Satoshi

AU - Nakahara, Jin

AU - Takahashi, Shinichi

AU - Suzuki, Norihiro

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Rationale: Recently, drug-related myasthenia gravis (MG) has received attention, because the number of reported cases involving MG associated with immune checkpoint inhibitors, a new immunotherapy, is increasing. We present a case involving the new onset of MG, in which the symptoms started shortly after intravesical Bacillus Calmette-Guerin (BCG) for bladder cancer. Patient concerns: A 69-year-old male with bladder cancer developed ptosis and diplopia 4 days after the completion of a treatment regimen with intravesical BCG weekly for 6 weeks. Diagnoses: Ocular MG was confirmed by a positive serum anti-acetylcholine receptor antibody test. Interventions: Treatment with high-dose methylprednisolone pulse therapy was given, after insufficient treatment with pyridostigmine bromide and 10 mg/d prednisolone. Outcomes: Symptoms resolved completely 12 days after high-dose methylprednisolone pulse therapy. Lessons: Intravesical BCG could be listed as a novel drug that may induce a new onset of MG along with drugs such as D-penicillamine and immune checkpoint inhibitors.

AB - Rationale: Recently, drug-related myasthenia gravis (MG) has received attention, because the number of reported cases involving MG associated with immune checkpoint inhibitors, a new immunotherapy, is increasing. We present a case involving the new onset of MG, in which the symptoms started shortly after intravesical Bacillus Calmette-Guerin (BCG) for bladder cancer. Patient concerns: A 69-year-old male with bladder cancer developed ptosis and diplopia 4 days after the completion of a treatment regimen with intravesical BCG weekly for 6 weeks. Diagnoses: Ocular MG was confirmed by a positive serum anti-acetylcholine receptor antibody test. Interventions: Treatment with high-dose methylprednisolone pulse therapy was given, after insufficient treatment with pyridostigmine bromide and 10 mg/d prednisolone. Outcomes: Symptoms resolved completely 12 days after high-dose methylprednisolone pulse therapy. Lessons: Intravesical BCG could be listed as a novel drug that may induce a new onset of MG along with drugs such as D-penicillamine and immune checkpoint inhibitors.

KW - Bladder cancer

KW - Drug-related

KW - Intravesical Bacillus Calmette-Guerin

KW - Myasthenia gravis

UR - http://www.scopus.com/inward/record.url?scp=85038005930&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038005930&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000008757

DO - 10.1097/MD.0000000000008757

M3 - Review article

VL - 96

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 46

M1 - e8757

ER -