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Nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis

A 79-year-old man with lymph node recurrence of malignant melanoma received nivolumab, an anti-programmed death 1 (PD-1) monoclonal antibody. He had pre-existing ocular myasthenia gravis (MG) and a continued small amount of corticosteroid. Grade 3 creatine phosphokinase elevation appeared after two...

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Autores principales: Maeda, Osamu, Yokota, Kenji, Atsuta, Naoki, Katsuno, Masahisa, Akiyama, Masashi, Ando, Yuichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nagoya University 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767520/
https://www.ncbi.nlm.nih.gov/pubmed/27019533
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author Maeda, Osamu
Yokota, Kenji
Atsuta, Naoki
Katsuno, Masahisa
Akiyama, Masashi
Ando, Yuichi
author_facet Maeda, Osamu
Yokota, Kenji
Atsuta, Naoki
Katsuno, Masahisa
Akiyama, Masashi
Ando, Yuichi
author_sort Maeda, Osamu
collection PubMed
description A 79-year-old man with lymph node recurrence of malignant melanoma received nivolumab, an anti-programmed death 1 (PD-1) monoclonal antibody. He had pre-existing ocular myasthenia gravis (MG) and a continued small amount of corticosteroid. Grade 3 creatine phosphokinase elevation appeared after two doses of nivolumab, and the treatment was postponed until it improved to grade 1. After three doses of nivolumab, he experienced diplopia and facial muscle weakness which were consistent with an acute exacerbation of MG, and the symptoms relieved without additional treatment for MG. He achieved shrinkage of metastasis after ten doses of nivolumab. Although a case who died due to MG after administration of nivolumab was reported recently, pre-existing MG is considered not to be always a contraindication of nivolumab.
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spelling pubmed-47675202016-03-25 Nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis Maeda, Osamu Yokota, Kenji Atsuta, Naoki Katsuno, Masahisa Akiyama, Masashi Ando, Yuichi Nagoya J Med Sci Case Report A 79-year-old man with lymph node recurrence of malignant melanoma received nivolumab, an anti-programmed death 1 (PD-1) monoclonal antibody. He had pre-existing ocular myasthenia gravis (MG) and a continued small amount of corticosteroid. Grade 3 creatine phosphokinase elevation appeared after two doses of nivolumab, and the treatment was postponed until it improved to grade 1. After three doses of nivolumab, he experienced diplopia and facial muscle weakness which were consistent with an acute exacerbation of MG, and the symptoms relieved without additional treatment for MG. He achieved shrinkage of metastasis after ten doses of nivolumab. Although a case who died due to MG after administration of nivolumab was reported recently, pre-existing MG is considered not to be always a contraindication of nivolumab. Nagoya University 2016-02 /pmc/articles/PMC4767520/ /pubmed/27019533 Text en http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Maeda, Osamu
Yokota, Kenji
Atsuta, Naoki
Katsuno, Masahisa
Akiyama, Masashi
Ando, Yuichi
Nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis
title Nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis
title_full Nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis
title_fullStr Nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis
title_full_unstemmed Nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis
title_short Nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis
title_sort nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767520/
https://www.ncbi.nlm.nih.gov/pubmed/27019533
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