PD-1 inhibitor-associated severe myasthenia gravis with necrotizing myopathy and myocarditis

In recent years, immune checkpoint inhibitors are widely used to treat unresectable malignancies. Programmed cell death protein 1 (PD-1) inhibitors (i.e., nivolumab, pembrolizumab), although effective for treating melanoma, non-small cell lung cancer, and other malignancies [1], can have undesired neurological side effects including myasthenia gravis (MG), myopathy, and peripheral neuropathy [2,4]. To date, 44 cases of PD-1 inhibitor-associated MG (pMG) are reported, with only a few reports of this condition concomitant with myocarditis [2,4].

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