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
N1 - Funding Information:
Editor: Masaki Shiota. TT and MK contributed equally. Funding/support: The study was funded by Japanese Ministry of Education, Science, Sports, and Culture (No. 17K09784); Health and Labour Sciences Research Grant on Rare and Intractable Diseases (Evidence-based Early Diagnosis and Treatment Strategies for Neuroimmunological Diseases) from the Ministry of Health, Labour, and Welfare of Japan; and Intramural Research Grant (29-4) for Neurological and Psychiatric Disorders of NCNP. Financial disclosure/conflicts of interest: The authors declare that they have no conflict of interest. Department of Neurology, Keio University School of Medicine, Tokyo, Japan. ∗Correspondence: Tsubasa Takizawa, Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan (e-mail: tsubasa.takizawa@z5.keio.jp). Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. Medicine (2017) 96:46(e8757) Received: 16 August 2017 / Received in final form: 16 October 2017 / Accepted: 19 October 2017 http://dx.doi.org/10.1097/MD.0000000000008757
Publisher Copyright:
Copyright © 2017 the Author(s)
PY - 2017/11
Y1 - 2017/11
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
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U2 - 10.1097/MD.0000000000008757
DO - 10.1097/MD.0000000000008757
M3 - Review article
C2 - 29145329
AN - SCOPUS:85038005930
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 -