A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer

BACKGROUND: Although rare, several immune-related adverse effects can be life-threatening. Here, we describe a metastatic gastric cancer patient presenting with nivolumab-related myasthenia gravis and myocarditis, a previously unreported adverse effect of gastric cancer treatment. CASE PRESENTATION:...

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Autores principales: Komatsu, Masaru, Hirai, Motoharu, Kobayashi, Kazuaki, Hashidate, Hideki, Fukumoto, Junki, Sato, Aki, Usuda, Hideki, Tanaka, Komei, Takahashi, Kazuyoshi, Kuwabara, Shirou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393464/
https://www.ncbi.nlm.nih.gov/pubmed/34445963
http://dx.doi.org/10.1186/s12876-021-01904-4
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author Komatsu, Masaru
Hirai, Motoharu
Kobayashi, Kazuaki
Hashidate, Hideki
Fukumoto, Junki
Sato, Aki
Usuda, Hideki
Tanaka, Komei
Takahashi, Kazuyoshi
Kuwabara, Shirou
author_facet Komatsu, Masaru
Hirai, Motoharu
Kobayashi, Kazuaki
Hashidate, Hideki
Fukumoto, Junki
Sato, Aki
Usuda, Hideki
Tanaka, Komei
Takahashi, Kazuyoshi
Kuwabara, Shirou
author_sort Komatsu, Masaru
collection PubMed
description BACKGROUND: Although rare, several immune-related adverse effects can be life-threatening. Here, we describe a metastatic gastric cancer patient presenting with nivolumab-related myasthenia gravis and myocarditis, a previously unreported adverse effect of gastric cancer treatment. CASE PRESENTATION: A 66-year-old man with metastatic gastric cancer visited the emergency department because of dizziness after the first dose of nivolumab. Diagnoses of nivolumab-related myasthenia gravis and myocarditis were established. Myocardial biopsy results and anti-acetylcholine receptor antibody positivity confirmed the diagnoses. Despite plasma exchange and intravenous methylprednisolone and immunoglobulin administration, the patient’s general condition gradually worsened, and he died. CONCLUSIONS: Strict monitoring for cardiac and neuromuscular symptoms after nivolumab administration is necessary to rapidly treat these adverse effects.
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spelling pubmed-83934642021-08-30 A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer Komatsu, Masaru Hirai, Motoharu Kobayashi, Kazuaki Hashidate, Hideki Fukumoto, Junki Sato, Aki Usuda, Hideki Tanaka, Komei Takahashi, Kazuyoshi Kuwabara, Shirou BMC Gastroenterol Case Report BACKGROUND: Although rare, several immune-related adverse effects can be life-threatening. Here, we describe a metastatic gastric cancer patient presenting with nivolumab-related myasthenia gravis and myocarditis, a previously unreported adverse effect of gastric cancer treatment. CASE PRESENTATION: A 66-year-old man with metastatic gastric cancer visited the emergency department because of dizziness after the first dose of nivolumab. Diagnoses of nivolumab-related myasthenia gravis and myocarditis were established. Myocardial biopsy results and anti-acetylcholine receptor antibody positivity confirmed the diagnoses. Despite plasma exchange and intravenous methylprednisolone and immunoglobulin administration, the patient’s general condition gradually worsened, and he died. CONCLUSIONS: Strict monitoring for cardiac and neuromuscular symptoms after nivolumab administration is necessary to rapidly treat these adverse effects. BioMed Central 2021-08-26 /pmc/articles/PMC8393464/ /pubmed/34445963 http://dx.doi.org/10.1186/s12876-021-01904-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Komatsu, Masaru
Hirai, Motoharu
Kobayashi, Kazuaki
Hashidate, Hideki
Fukumoto, Junki
Sato, Aki
Usuda, Hideki
Tanaka, Komei
Takahashi, Kazuyoshi
Kuwabara, Shirou
A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer
title A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer
title_full A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer
title_fullStr A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer
title_full_unstemmed A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer
title_short A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer
title_sort rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393464/
https://www.ncbi.nlm.nih.gov/pubmed/34445963
http://dx.doi.org/10.1186/s12876-021-01904-4
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