A Case of Asymptomatic Immune Checkpoint Inhibitor-associated Myocarditis.

A Case of Asymptomatic Immune Checkpoint Inhibitor-associated Myocarditis. Intern Med. 2020 Oct 07;: Authors: Tanabe J, Watanabe N, Endo A, Nagami T, Inagaki S, Tanabe K Abstract We herein report the case of a 75-year-old man with asymptomatic immune checkpoint inhibitor (ICI)-associated myocarditis diagnosed on the basis of elevated levels of creatine kinase (CK), CK-myocardial band and troponin I (TNI). He was suspected of being complicated with myasthenia gravis (MG). High-dose prednisolone (PSL) is associated with a risk of MG exacerbation; therefore, PSL therapy was gradually increased from 5 mg/day to 20 mg/day, which resulted in the normalization of the TNI level, and no PSL-related side effects occurred. MG easily complicates myocarditis as an immune-related adverse event; thus, the treatment plan should be carefully considered. PMID: 33028770 [PubMed - as supplied by publisher]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research

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Source: Melanoma Research - Category: Cancer & Oncology Tags: Original Articles: Clinical Research Source Type: research
AbstractAnti ‐striational antibodies (StrAbs) have been described as serum immunoglobulins that react with cross‐striations of skeletal muscle in patients with myasthenia gravis (MG). StrAbs were expected to be useful biomarkers of MG, however, because of their low specificity, the diagnostic utility of StrA bs has been limited. The main autoantigens of StrAbs included titin, ryanodine receptor, and Kv1.4. MG patients with StrAbs tend to suffer from bulbar symptoms and myasthenic crisis. The most remarkable finding of regarding the clinical significance of StrAbs is their association with myositis conco mitant with MG....
Source: Clinical and Experimental Neuroimmunology - Category: Neurology Authors: Tags: REVIEW ARTICLE Source Type: research
Marked elevation of serum creatine phosphokinase (CPK) always appears as a clinical emergency, including inflammatory myopathies, rhabdomyolysis, and neuromuscular diseases. Moreover, immunotherapy-associated high CPK often binds to fatal adverse events (myocarditis, myositis, and myasthenia gravis) [1]. However, we describe an interesting case of high-CPK asymptomatic hypothyroid myopathy after Sintilimab [2] (a novel PD-1 inhibitor developed by a Chinese company) treatment for non small-cell lung cancer.
Source: European Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Letter to the Editor Source Type: research
Publication date: Available online 26 February 2020Source: Urology Case ReportsAuthor(s): Manabu Takai, Daiki Kato, Koji Iinuma, Yuka Muramatsu Maekawa, Keita Nakane, Tomohiro Tsuchiya, Shigeaki Yokoi, Takuya Koie
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AbstractImmune checkpoint inhibitors (ICI) induce improved clinical outcomes associated with numerous cancers, but immune-related adverse events can occur, including neuromuscular complications. We searched for all muscle biopsies from the patient data system of University Hospitals Leuven (UZ Leuven) from January 2014 to July 2018 (n = 686) and collected clinical data of patients with a biopsy-proven ICI-related myositis and expanded the pathological examinations. We identified three cases of ICI-related myositis in patients with malignant melanoma. The clinical phenotype ranged from mild to life threatening...
Source: Acta Neurologica Belgica - Category: Neurology Source Type: research
Purpose of review Ocular myasthenia gravis (OMG) is a complex condition with heterogenous phenotypes and ill-defined diagnostic criteria. Understanding concomitant risk factors and autoimmune serology can help inform prognosis for generalization and guide treatment. Recent findings Although antibodies to acetylcholine receptors or muscle-specific kinase likely increase risk of generalization, they are less frequent in OMG. Patients without either antibody tend to have a milder disease process and often have variable antibodies to other end-plate proteins such as LRP4, agrin, or cortactin. The treatment of OMG begins w...
Source: Current Opinion in Neurology - Category: Neurology Tags: NEURO-OPHTHALMOLOGY: Edited by Heather E. Moss Source Type: research
ConclusionA characteristic clinic-pathological pattern, including a myasthenia gravis-like syndrome plus myositis was found in patients receiving PD-1 and PD-1 L inhibitors. A large component of macrophages resembling granulomas seems to be the pathological hallmark of the syndrome. Further information is required to understand the wide spectrum of immune-related adverse events involving the muscle during or after treatment with anti-PD-1 inhibitors, but the pathological picture seems to be characteristic.
Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research
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Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: REVIEW ARTICLES Source Type: research
Immune-checkpoint inhibitors (ICIs) are novel therapeutic agents that have demonstrated relevant anti-tumor responses in multiple cancer types. They produce a potentiation of the immune response against the cancer by blocking the negative down-regulation of T cells. Checkpoint inhibitor-associated neurological side effects are rare but also potentially life-threatening [1].
Source: Neuromuscular Disorders - Category: Neurology Authors: Tags: Case report Source Type: research
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Source: Frontiers in Neurology - Category: Neurology Source Type: research
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