Hasegawa Yoshikazu, Kawai Shigeru, Ota Takayo, Tsukuda Hiroshi, Fukuoka Masahiro
Department of Medical Oncology, Izumi Municipal Hospital, Izumi, Japan.
Department of Neurology, Kindai University Faculty of Medicine, Osaka-sayama, Japan.
Immunotherapy. 2017 Aug;9(9):701-707. doi: 10.2217/imt-2017-0043. Epub 2017 Jun 26.
A 76-year-old woman who was diagnosed with non-small-cell lung cancer presented with left eyelid ptosis and grade 4 creatine phosphokinase elevation after the second cycle of nivolumab monotherapy. Nivolumab has demonstrated promising efficacy in patients with non-small-cell lung cancer in several trials. Dyspnea and muscle weakness developed rapidly with an acute exacerbation. She underwent plasmapheresis and intravenous immune globulin followed by treatment with low-dose prednisolone. She had gradual symptoms improvement. We diagnosed her with myasthenia gravis (MG) based on her symptoms and the detection of anti-acetylcholine receptor antibody. According to postmarketing surveillance in 15,740 Japanese patients, the total incidence rate of MG is 0.1%. We report a rare case of drug-induced MG in a patient receiving nivolumab.
一名76岁被诊断为非小细胞肺癌的女性，在接受纳武单抗单药治疗的第二个周期后出现左眼睑下垂和肌酸磷酸激酶4级升高。纳武单抗在多项试验中已证明对非小细胞肺癌患者有良好疗效。呼吸困难和肌肉无力迅速出现并急性加重。她接受了血浆置换和静脉注射免疫球蛋白，随后接受低剂量泼尼松龙治疗。她的症状逐渐改善。根据她的症状和抗乙酰胆碱受体抗体检测，我们诊断她患有重症肌无力（MG）。根据对15740名日本患者的上市后监测，MG的总发病率为0.1%。我们报告了一例接受纳武单抗治疗的患者发生药物性MG的罕见病例。
