Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan.
Department of Community Medicine, Faculty of Medical Science, University of Fukui, Japan.
Intern Med. 2023;62(20):3013-3020. doi: 10.2169/internalmedicine.0739-22. Epub 2023 Oct 15.
Nivolumab blocks inhibitors of T-cell activation and restores antitumor immunity but promotes T-cell activity in host tissues by blocking inhibition of the T-cell function, resulting in immune-related adverse effects. We herein report an 80-year-old man presenting with nivolumab-related myasthenia gravis with anti-muscular voltage-gated potassium channel-complex (Kv1.4) antibodies. On day 29 after nivolumab administration, he simultaneously developed rapidly progressing right ptosis and left facial paralysis. Nivolumab administration was discontinued. He subsequently presented with bulbar paralysis, dyspnea, and muscle weakness and received intravenous immunoglobulin, methylprednisolone, and plasma exchange. The severity of nivolumab-related myasthenia gravis with anti-Kv1.4 antibodies presented with diverse clinical findings.
纳武利尤单抗阻断 T 细胞激活抑制剂并恢复抗肿瘤免疫，但通过阻断 T 细胞功能的抑制促进宿主组织中的 T 细胞活性，从而导致免疫相关不良事件。我们在此报告一例 80 岁男性，因纳武利尤单抗相关重症肌无力伴抗肌肉电压门控钾通道复合物（Kv1.4）抗体。纳武利尤单抗给药后第 29 天，他同时出现进行性右侧上睑下垂和左侧面瘫。停止纳武利尤单抗给药。随后他出现延髓性麻痹、呼吸困难和肌无力，并接受了静脉注射免疫球蛋白、甲基强的松龙和血浆置换。纳武利尤单抗相关重症肌无力伴抗 Kv1.4 抗体的严重程度表现出不同的临床表现。
