General Medicine Department, St John of God Midland Public Hospital, Perth, Western Australia, Australia.
Neurology Department, St John of God Midland Public Hospital, Perth, Western Australia, Australia.
Intern Med J. 2020 Aug;50(8):1003-1006. doi: 10.1111/imj.14946.
An 82-year-old man was treated with neo-adjuvant nivolumab (programmed cell death protein 1 or PD-1 inhibitor) for local recurrence of melanoma developed myositis, myocarditis and a myasthenic-like syndrome with a fatal outcome. The occurrence of these three conditions may constitute a new immune checkpoint-induced syndrome. The relevance of the clinical features and the immunology is discussed. This case highlights the special role of anti-striated muscle antibodies as a predictor of mortality.
一位 82 岁男性因黑色素瘤局部复发接受了新辅助纳武利尤单抗（程序性死亡蛋白 1 或 PD-1 抑制剂）治疗，出现了肌炎、心肌炎和肌无力样综合征，并导致了致命结局。这三种情况的发生可能构成一种新的免疫检查点诱导综合征。讨论了临床特征和免疫学的相关性。该病例突出了抗横纹肌抗体作为死亡率预测指标的特殊作用。
