PMID- 31246640
OWN - NLM
STAT- MEDLINE
DCOM- 20200703
LR  - 20200703
IS  - 1537-4513 (Electronic)
IS  - 1524-9557 (Linking)
VI  - 42
IP  - 8
DP  - 2019 Oct
TI  - Myasthenia Gravis Induced by Immune Checkpoint Inhibitors.
PG  - 309-312
LID - 10.1097/CJI.0000000000000278 [doi]
AB  - Immune checkpoint inhibitors deeply improved the prognosis of metastatic melanoma 
      or other types of cancer, but their related adverse effects (AEs) can be very 
      severe, especially when the neurological system is touched, as in myasthenia 
      gravis (MG). It is a rare immune AE that can be life-threatening and can be 
      revealed by several symptoms. We report a case of our experience and review the 
      current literature of MG exacerbated or occurring during immunotherapy to 
      describe characteristics of this AE, warn the oncologist about this toxicity, and 
      summarize the treatments conducted. Thirty-four cases of MG were reported, mostly 
      with anti-programmed cell death protein 1 checkpoint inhibitor, and with 
      melanoma. Onset was quick after the first or second infusion. Treatment comprised 
      corticosteroids, prostigmine, and more or less plasmapheresis or immunoglobulins. 
      Prognosis is poor, as 13 patients died after MG. MG is a rare immune-related AE 
      that must be rapidly evoked and treated in case of neurological symptoms emerging 
      after immunotherapy.
FAU - Becquart, Ondine
AU  - Becquart O
AD  - Departments of Dermatology.
FAU - Lacotte, Julie
AU  - Lacotte J
AD  - Departments of Dermatology.
FAU - Malissart, Pauline
AU  - Malissart P
AD  - Neurology.
FAU - Nadal, Jeremy
AU  - Nadal J
AD  - Ophthalmology, Hospital of Montpellier and Montpellier University, Montpellier, 
      France.
FAU - Lesage, Candice
AU  - Lesage C
AD  - Departments of Dermatology.
FAU - Guillot, Bernard
AU  - Guillot B
AD  - Departments of Dermatology.
FAU - Du Thanh, Aurelie
AU  - Du Thanh A
AD  - Departments of Dermatology.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Immunother
JT  - Journal of immunotherapy (Hagerstown, Md. : 1997)
JID - 9706083
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 0 (PDCD1 protein, human)
RN  - 0 (Programmed Cell Death 1 Receptor)
RN  - 31YO63LBSN (Nivolumab)
RN  - 3982TWQ96G (Neostigmine)
SB  - IM
MH  - Aged
MH  - Antineoplastic Agents, Immunological/*adverse effects
MH  - Female
MH  - Humans
MH  - Melanoma/drug therapy
MH  - Myasthenia Gravis/drug therapy/*etiology
MH  - Neostigmine/therapeutic use
MH  - Nivolumab/*adverse effects
MH  - Programmed Cell Death 1 Receptor/*antagonists & inhibitors
EDAT- 2019/06/28 06:00
MHDA- 2020/07/04 06:00
CRDT- 2019/06/28 06:00
PHST- 2019/06/28 06:00 [pubmed]
PHST- 2020/07/04 06:00 [medline]
PHST- 2019/06/28 06:00 [entrez]
AID - 10.1097/CJI.0000000000000278 [doi]
PST - ppublish
SO  - J Immunother. 2019 Oct;42(8):309-312. doi: 10.1097/CJI.0000000000000278.