Immune checkpoint inhibitors in the onset of myasthenia gravis with hyperCKemia

Ann Clin Transl Neurol. 2018 Sep 23;5(11):1421-1427. doi: 10.1002/acn3.654. eCollection 2018 Nov.

Abstract

Immune checkpoint inhibitors sometimes cause neuromuscular adverse events. Although a few cases of myasthenia gravis with hyperCKemia triggered by immune checkpoint inhibitors have been described, conclusive evidence remains limited. We conducted a systematic review of published cases of myasthenia gravis with hyperCKemia related to immune checkpoint inhibitors. Moreover, we tested anti-striational antibodies in the case of myasthenia gravis with myositis after nivolumab administration. We located 17 published case reports. Anti-striational antibodies were tested in six cases and five cases were positive. Our systematic analyses revealed poor prognosis in myasthenia gravis combined hyperCKemia with immune checkpoint inhibitors.

Grants and funding

This work was funded by Japan Society for the Promotion of Science JSPS KAKENHI grants JP17K09781 and JP16K09695.