A case of anti-titin antibody positive nivolumab-related necrotizing myopathy with myasthenia gravis

Aiko Isami, Ayaka Uchiyama, Yuichi Shimaoka, Shigeaki Suzuki, Izumi Kawachi, Nobuya Fujita

研究成果: Article

抜粋

A 53-year-old man suffering from squamous cell lung cancer presented with bilateral ptosis and bulbar palsy a month after initial treatment with the immune checkpoint inhibitor nivolumab. The symptoms showed worsening from midday, suggesting myasthenia gravis (MG), although anti-AChR antibody was negative. Although no muscle weakness was detected, the CK level was elevated to 5,255 IU/l, and MRI of the thigh revealed inflammation of the bilateral rectus femoris muscle. A muscle biopsy showed signs of necrotizing myopathy with expression of sarcolemmal HLA class I and accumulation of macrophages, CD4, CD8, and CD20-positive lymphocytes. Positivity for anti-titin antibody, one of the anti-striated muscle antibodies, was evident. The patient was diagnosed as having nivolumab-related necrotizing myopathy with myasthenia gravis, an immune-related adverse event (irAE). Treatment with prednisolone rapidly ameliorated the symptoms, and the serum CK level normalized. There have been several reports of nivolumab-related myositis with MG. On the basis of the muscle pathology and antibody data, we were able to clarify that necrotizing myopathy was related to the pathogenesis of this case.

元の言語English
ページ(範囲)431-435
ページ数5
ジャーナルRinsho shinkeigaku = Clinical neurology
59
発行部数7
DOI
出版物ステータスPublished - 2019 7 31

ASJC Scopus subject areas

  • Clinical Neurology

フィンガープリント A case of anti-titin antibody positive nivolumab-related necrotizing myopathy with myasthenia gravis' の研究トピックを掘り下げます。これらはともに一意のフィンガープリントを構成します。

  • これを引用