Immune Checkpoint Inhibition-Related Myasthenia-Myositis-Myocarditis Responsive to Complement Blockade
We present a case of severe myasthenia-myositis-myocarditis overlap in a patient receiving ICIs for breast cancer. Clinical findings were recorded.
Results
A 47-year-old woman developed tetraparesis, dysphagia, and muscle pain during ICI treatment. MG with a thymoma had been diagnosed earlier. Neuromuscular overlap irAEs with cardiac affection was confirmed, and ICI treatment was discontinued. Given a lack of clinical response to standard therapies, a muscle biopsy was performed demonstrating complement deposition. Eculizumab treatment led to rapid improvement in muscle strength and cardiac function.
Discussion
Neuromuscular irAEs are associated with a high in-hospital mortality, and specific treatment strategies remain an unmet need. Here, early muscle biopsy enabled targeted therapy after standard approaches failed, thereby highlighting the value of identifying a specific treatment target. To improve therapeutic outcomes, the development of patient-tailored strategies for neuromuscular irAEs requires further studies.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Nelke, C., Pawlitzki, M., Kerkhoff, R., Schroeter, C. B., Aktas, O., Neuen-Jacob, E., Polzin, A., Meuth, S. G., Ruck, T. Tags: Autoimmune diseases, All Neuromuscular Disease, Myasthenia Clinical/Scientific Note Source Type: research
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