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Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis
Nivolumab is a checkpoint inhibitor approved to treat various solid organs malignancies. Although checkpoint inhibitors are very efficacious, these medications are also associated with a variety of side effects that could be life-threatening. We present a case of nivolumab-induced myasthenia gravis...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510662/ https://www.ncbi.nlm.nih.gov/pubmed/34691341 http://dx.doi.org/10.14740/jmc3783 |
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author | Tahir, Nayha Mahboob, Anber Piao, Xuanzhen Ying, Grace Shrestha, Jishna Sherchan, Robin Zahra, Farha |
author_facet | Tahir, Nayha Mahboob, Anber Piao, Xuanzhen Ying, Grace Shrestha, Jishna Sherchan, Robin Zahra, Farha |
author_sort | Tahir, Nayha |
collection | PubMed |
description | Nivolumab is a checkpoint inhibitor approved to treat various solid organs malignancies. Although checkpoint inhibitors are very efficacious, these medications are also associated with a variety of side effects that could be life-threatening. We present a case of nivolumab-induced myasthenia gravis in a patient with stage IV esophageal cancer, who was found to have generalized weakness, blurry vision, diplopia, and later developed acute hypoxic respiratory failure with subsequent intubation. The patient was treated with intravenous immunoglobulin and plasmapheresis, and later started on pyridostigmine and high-dose steroids with minimal improvement. Goals of care were discussed with the patient and family, and the decision was made to discharge the patient home with hospice care. Nivolumab-induced myasthenia gravis is very aggressive with a poor prognosis if not appropriately managed in time. Hence we strongly recommend a multidisciplinary approach, including neurologists, to monitor patients on nivolumab therapy to reduce morbidity and mortality associated with it. |
format | Online Article Text |
id | pubmed-8510662 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-85106622021-10-22 Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis Tahir, Nayha Mahboob, Anber Piao, Xuanzhen Ying, Grace Shrestha, Jishna Sherchan, Robin Zahra, Farha J Med Cases Case Report Nivolumab is a checkpoint inhibitor approved to treat various solid organs malignancies. Although checkpoint inhibitors are very efficacious, these medications are also associated with a variety of side effects that could be life-threatening. We present a case of nivolumab-induced myasthenia gravis in a patient with stage IV esophageal cancer, who was found to have generalized weakness, blurry vision, diplopia, and later developed acute hypoxic respiratory failure with subsequent intubation. The patient was treated with intravenous immunoglobulin and plasmapheresis, and later started on pyridostigmine and high-dose steroids with minimal improvement. Goals of care were discussed with the patient and family, and the decision was made to discharge the patient home with hospice care. Nivolumab-induced myasthenia gravis is very aggressive with a poor prognosis if not appropriately managed in time. Hence we strongly recommend a multidisciplinary approach, including neurologists, to monitor patients on nivolumab therapy to reduce morbidity and mortality associated with it. Elmer Press 2021-10 2021-09-29 /pmc/articles/PMC8510662/ /pubmed/34691341 http://dx.doi.org/10.14740/jmc3783 Text en Copyright 2021, Tahir et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Tahir, Nayha Mahboob, Anber Piao, Xuanzhen Ying, Grace Shrestha, Jishna Sherchan, Robin Zahra, Farha Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis |
title | Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis |
title_full | Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis |
title_fullStr | Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis |
title_full_unstemmed | Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis |
title_short | Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis |
title_sort | nivolumab, a double-edged sword: a case report of nivolumab-induced myasthenia gravis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510662/ https://www.ncbi.nlm.nih.gov/pubmed/34691341 http://dx.doi.org/10.14740/jmc3783 |
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