Department of Internal Medicine, Chonnam National University Medical School, and Chonnam National University Hwasun Hospital, Hwasun, South Korea.
Department of Neurology, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea.
Thorac Cancer. 2019 Oct;10(10):2045-2049. doi: 10.1111/1759-7714.13177. Epub 2019 Aug 21.
Here, we report a case of myasthenia gravis and myopathy in a patient treated with nivolumab. A 76-year-old man who had been treated with four doses of nivolumab because of non-small cell lung cancer (NSCLC) presented with proximal-dominant muscle weakness and fluctuating ptosis and diplopia. Serologic studies revealed increased levels of muscle enzymes including creatine phosphokinase (2934 U/L), and acetylcholine receptor antibody was positive (1.31 nmol/L). Following electrodiagnostic study, he was diagnosed with myasthenia gravis and active stage of myopathy. After discontinuation of nivolumab, he was treated with corticosteroids, intravenous immunoglobulin G, and pyridostigmine. The neuromuscular symptoms and serologic abnormalities of the patient markedly improved. Currently, he is taking oral steroids and pyridostigmine without further immunotherapy.
在此，我们报告了一例接受nivolumab 治疗的重症肌无力和肌病患者。一名 76 岁男性因非小细胞肺癌（NSCLC）接受了四剂 nivolumab 治疗，出现以近端为主的肌肉无力、波动性上睑下垂和复视。血清学研究显示肌肉酶水平升高，包括肌酸磷酸激酶（2934 U/L），乙酰胆碱受体抗体阳性（1.31 nmol/L）。电诊断研究后，他被诊断为重症肌无力和肌病活动期。停用 nivolumab 后，他接受了皮质类固醇、静脉注射免疫球蛋白 G 和吡啶斯的明治疗。患者的神经肌肉症状和血清学异常明显改善。目前，他正在服用口服类固醇和吡啶斯的明，不再进行免疫治疗。
