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Case Reports
. 2021 May 22;13(5):e15174.
doi: 10.7759/cureus.15174.

Pembrolizumab-Associated Seronegative Myasthenia Gravis in a Patient With Metastatic Renal Cell Carcinoma

Shaunak K Pandya  1 , Matthew Ulrickson  2 , JiaXi Dong  1 , Ryan Willen  1 , Arati Pandya  1
Affiliations
Case Reports

Pembrolizumab-Associated Seronegative Myasthenia Gravis in a Patient With Metastatic Renal Cell Carcinoma

Shaunak K Pandya et al. Cureus. .

Abstract

Seronegative myasthenia gravis is a rare, but potential adverse effect of immune checkpoint inhibition. There have been few but increasing number of cases reported in recent years, and early recognition is important for prompt diagnosis and management. Here, we describe the case of a 65-year-old male with metastatic renal cell carcinoma on pembrolizumab diagnosed with new-onset seronegative myasthenia gravis and review literature on its management.

Keywords: autoimmune; checkpoint inhibitors; intravenous immunoglobulin (ivig); myasthenia gravis; pembrolizumab; renal cell carcinoma (rcc); seronegative.

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Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. PD-L2 is a second ligand for PD-1 and inhibits T cell activation. Latchman Y, Wood CR, Chernova T, et al. Nat Immunol. 2001;2:261–268. - PubMed
    1. PD-1 and its ligands in tolerance and immunity. Keir ME, Butte MJ, Freeman GJ, Sharpe AH. Annu Rev Immunol. 2008;26:677–704. - PMC - PubMed
    1. Development of the inhibitors that target the PD-1/PD-L1 interaction-a brief look at progress on small molecules, peptides and macrocycles. Guzik K, Tomala M, Muszak D, et al. Molecules. 2019;24:2071. - PMC - PubMed
    1. Myasthenia gravis: an emerging toxicity of immune checkpoint inhibitors. Makarious D, Horwood K, Coward JIG. Eur J Cancer. 2017;82:128–136. - PubMed
    1. Pembrolizumab-induced myasthenia gravis (P4.2-007) Algaeed M, Mukharesh L, Heinzelmann M, Kaminski HJ. https://n.neurology.org/content/92/15_Supplement/P4.2-007.abstract. Neurology. 2019;92:15. - PubMed

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