Immune checkpoint inhibitor-mediated myasthenia gravis with focal subclinical myocarditis progressing to symptomatic cardiac disease. Issue 5 (13th May 2020)

• Record Type: Journal Article
• Authors: Leaver, Phillip John; Jang, Helena Sung-In; Vernon, Stephen Thomas; Fernando, Suran Loshana
• Is Part Of: BMJ case reports. Volume 13:Issue 5(2020)
• Publication Date: 2020-05-13
• Subjects: heart failure -- radiology (diagnostics) -- malignant disease and immunosuppression -- skin cancer -- unwanted effects / adverse reactions; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-232920
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : The advent of immune checkpoint inhibitors (ICIs) for cancer therapy has heralded increasing frequency of immune-related adverse events including endocrinopathies, hepatitis, colitis and rarely myocarditis and myasthenia gravis (MG). The heterogeneity in clinical presentations regardless of organ-specific involvement can lead to delayed recognition and management of these events and adverse health outcomes. We describe a case of ICI-induced subclinical focal myocarditis that was recognised and treated in the broader context of MG. It is essential that patients with ICI-induced MG should be screened and monitored for myocarditis, a potentially fatal complication.