Lethal Immune Myocarditis and Myasthenia Gravis Due to Anti-PD-1 Treatment for a Bladder Cancer Patient: A Case Report and Possible Treatment Inspiration

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL

International Medical Case Reports Journal Pub Date : 2024-04-01 DOI:10.2147/IMCRJ.S449525

Pan Gao, Xinyu Li, Ziqiu He, Hongbo Zhang, Zhi Zhang, Zonglai Liu

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引用次数: 0

Abstract

Abstract Immune checkpoint inhibitors (ICI) have become a new hope for many patients with advanced cancer by blocking tumor immune escape. Bladder cancer is a common malignant tumor of the urinary tract epithelium that often relapses and metastasizes after surgery, chemotherapy, and radiotherapy. Immunotherapy has dramatically improved patient survival rates and clinical benefits as a new, potentially effective therapy. However, avoidance of various immune-related adverse events (irAEs) remains an implausible idea. ICI-induced myocarditis is different from viral myocarditis, and mortality is still high with the current treatment. We report the case of an 82-year-old female patient with ICI-induced fulminant myocarditis and myasthenia gravis. Although she actively accepted the current mainstream treatment for immune-related myocarditis and myasthenia, she died of heart and respiratory failure. Analyzing and reporting the patient’s disease development process and the changes in related indicators may help peers gain a deeper understanding of immune-related adverse events and reduce the mortality of immune-related myocarditis.

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一名膀胱癌患者因接受抗PD-1治疗而引发致命的免疫性心肌炎和重症肌无力：病例报告和可能的治疗启示

摘要免疫检查点抑制剂（ICI）通过阻断肿瘤免疫逃逸，已成为许多晚期癌症患者的新希望。膀胱癌是一种常见的泌尿道上皮恶性肿瘤，常在手术、化疗和放疗后复发和转移。免疫疗法作为一种潜在有效的新疗法，大大提高了患者的生存率和临床疗效。然而，避免各种免疫相关不良事件（irAEs）仍然是一个难以置信的想法。ICI 引发的心肌炎不同于病毒性心肌炎，目前的治疗方法死亡率仍然很高。我们报告了一例 82 岁女性 ICI 诱导的暴发性心肌炎和重症肌无力患者的病例。虽然她积极接受了目前治疗免疫相关性心肌炎和肌无力的主流方法，但还是死于心脏和呼吸衰竭。分析和报告患者的疾病发展过程和相关指标的变化，有助于同行更深入地了解免疫相关不良事件，降低免疫相关心肌炎的死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Medical Case Reports Journal MEDICINE, GENERAL & INTERNAL-

CiteScore

1.40

自引率

0.00%

发文量

135

审稿时长

16 weeks

期刊介绍： International Medical Case Reports Journal is an international, peer-reviewed, open access, online journal publishing original case reports from all medical specialties. Submissions should not normally exceed 3,000 words or 4 published pages including figures, diagrams and references. As of 1st April 2019, the International Medical Case Reports Journal will no longer consider meta-analyses for publication.