<p>Immune checkpoint inhibitors can cause immune-related adverse events, with neurologic manifestations such as myasthenia gravis (MG) and myositis predominantly reported with PD-1 inhibitors, while cases linked to PD-L1 inhibitors remain rare. An 84-year-old man with hepatocellular carcinoma developed severe MG and myositis after atezolizumab treatment. Despite intensive therapy, including corticosteroids, plasma exchange, and intravenous immunoglobulin, his condition worsened, and he died. MG in cancer patients poses treatment challenges due to tumor progression and functional decline. Given the limited reports on atezolizumab-induced MG, further case accumulation is essential to improve understanding of its clinical course and optimize management strategies.</p>

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Atezolizumab-induced myasthenia gravis and myositis: a fatal case report and review of the literature

  • Yuya Kobayashi,
  • Kiyoshiro Nagamatsu,
  • Yusaku Shimizu,
  • Ataru Nakayama,
  • Yoshiki Sekijima

摘要

Immune checkpoint inhibitors can cause immune-related adverse events, with neurologic manifestations such as myasthenia gravis (MG) and myositis predominantly reported with PD-1 inhibitors, while cases linked to PD-L1 inhibitors remain rare. An 84-year-old man with hepatocellular carcinoma developed severe MG and myositis after atezolizumab treatment. Despite intensive therapy, including corticosteroids, plasma exchange, and intravenous immunoglobulin, his condition worsened, and he died. MG in cancer patients poses treatment challenges due to tumor progression and functional decline. Given the limited reports on atezolizumab-induced MG, further case accumulation is essential to improve understanding of its clinical course and optimize management strategies.