発症 1 年後の抗横紋筋抗体を追跡し得た免疫チェックポイント阻害薬に関連した筋炎合併重症筋無力症の 1 例

Yukio Sugiyama, Yoshiki Esa, Akihiro Watanabe, Junya Kobayashi, Shigeaki Suzuki, Daisuke Takahashi

研究成果: Article査読

2 被引用数 (Scopus)

抄録

A 78-year-old man was treated with ipilimumab and nivolumab for advanced renal cell carcinoma with liver and lymph node metastasis. He developed diplopia, ptosis, dysphagia, and weakness of the limbs and neck, 1 month after treatment. Serum creatine kinase (CK) levels were elevated, and neck MRI revealed inflammation of the deep trunk muscles. Although anti-acetylcholine receptor antibody was negative, the edrophonium test was positive. Anti-striational antibodies such as the anti-titin and the anti-muscular voltage-gated potassium channel (Kv 1.4) antibodies (which serve as biomarkers of immune checkpoint inhibitors associated with myasthenia gravis and myositis) were positive (anti-titin antibody titer 11.51, normal <1 index; anti-Kv 1.4 antibody titer 15.13, normal <1 index). Intravenous methylprednisolone pulse therapy (1,000 mg/day for 3 days), plasmapheresis, and oral prednisolone (PSL) (20 mg/day) administration improved the patient's neurological function and normalized the serum CK levels. The PSL dosage was tapered without any worsening of clinical signs. The antibody titers decreased but remained positive (anti-titin antibody 5.00, anti-Kv 1.4 antibody 3.83) one year after the initial evaluation. Therefore, low-dose PSL (5 mg/day) administration was continued, and the patient was in remission.

寄稿の翻訳タイトルImmune checkpoint inhibitor-induced anti-striational antibodies in myasthenia gravis and myositis: A case report
本文言語Japanese
ページ(範囲)630-634
ページ数5
ジャーナルClinical Neurology
61
9
DOI
出版ステータスPublished - 2021

Keywords

  • Anti-striational antibody
  • Immune checkpoint inhibitor
  • Immune-related adverse events
  • Myasthenia gravis
  • Myositis

ASJC Scopus subject areas

  • 臨床神経学

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「発症 1 年後の抗横紋筋抗体を追跡し得た免疫チェックポイント阻害薬に関連した筋炎合併重症筋無力症の 1 例」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

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