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CASE REPORT
Year : 2022  |  Volume : 9  |  Issue : 4  |  Page : 153-155

Triad of myasthenia gravis, myositis, and myocarditis after nivolumab administration in a patient with cholangiocarcinoma


1 Division of Medical Oncology, Department of Oncology; Center of Immuno-Oncology, Department of Oncology; Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2 Division of Medical Oncology, Department of Oncology; Center of Immuno-Oncology, Department of Oncology, Taipei Veterans General Hospital; Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

Correspondence Address:
Dr. Ming-Huang Chen
Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 11217; School of Medicine, National Yang Ming Chiao Tung University, Taipei
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2311-3006.362636

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Immune checkpoint inhibitors, including anti-programmed death receptor-1/ligand-1 drugs and anticytotoxic T lymphocyte-associated antigens, are novel drugs for the treatment of many cancers. However, they may rarely cause neurological immune-related adverse effects, including immune-related myasthenia gravis (MG). This condition leads to poorer clinical outcomes, especially when coexisting with myositis or myocarditis. We report a case of a patient with advanced cholangiocarcinoma along with a history of thymoma in whom a triad of MG, myositis, and myocarditis developed after nivolumab administration. Early recognition of neuromuscular symptoms remains critical to successful management.


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