ArticleCase reports in immunology2019
Severe Myositis, Myocarditis, and Myasthenia Gravis with Elevated Anti-Striated Muscle Antibody following Single Dose of Ipilimumab-Nivolumab Therapy in a Patient with Metastatic Melanoma.
Article in Case reports in immunology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 6 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 6 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Cardiovascular Immune-Related Adverse Events of Immune Checkpoint Inhibitors: A Systematic Review and Meta-Summary of Case Reports.Cancer reports (Hoboken, N.J.) · 2026Pooled it
- Triple-M syndrome after immune checkpoint inhibitors: a systematic review of cases-early recognition is critical to survival.Frontiers in neurology · 2026Pooled it
- Cardiac Toxicity Associated with Immune Checkpoint Inhibitors: A Systematic Review.International journal of molecular sciences · 2022Pooled it
- Exploring the role of immune checkpoint inhibitors in the etiology of myasthenia gravis and Lambert-Eaton myasthenic syndrome: A systematic review.Frontiers in neurology · 2022Pooled it
- A systematic review of myasthenia gravis complicated with myocarditis.Brain and behavior · 2021Pooled it
- Incidence and Distinct Features of Immune Checkpoint Inhibitor-Related Myositis From Idiopathic Inflammatory Myositis: A Single-Center Experience With Systematic Literature Review and Meta-Analysis.Frontiers in immunology · 2021Pooled it
- Review
- Immune Checkpoint Inhibitor-Associated Myocarditis With Myositis/Myasthenia Gravis Overlap Syndrome: Two Case Reports Highlighting Early Onset, Diagnostic Uncertainty, and Management Considerations.Clinical case reports · 2026Article
- Case Report and literature review: immune checkpoint inhibitor-associated myasthenia gravis and myocarditis.Frontiers in cardiovascular medicine · 2026Article
- Case Report: Immune checkpoint inhibitor-induced myositis/myocarditis with myasthenia gravis-like symptoms in a colon cancer patient with suspected thymic metastasis.Frontiers in oncology · 2026Article
- Use of rituximab for fulminant and refractory cases of immune checkpoint inhibitor induced myocyte injury clinically presenting with features of myasthenia gravis: a case series.European heart journal. Case reports · 2025Article
- Immune checkpoint inhibitor-associated myocarditis: a historical and comprehensive review.American journal of physiology. Heart and circulatory physiology · 2025Review
- Article
- Elevated Creatine Kinase (CK) and Myositis Triggered by Immune Checkpoint Inhibitors: Muscle Mysteries Unveiled.Cureus · 2024Article
- Clinical characteristics and influencing factors of anti-PD-1/PD-L1-related severe cardiac adverse event: based on FAERS and TCGA databases.Scientific reports · 2024Article
- Therapeutic agents for steroid-refractory immune checkpoint inhibitor-related myocarditis: a narrative review.Cardiovascular diagnosis and therapy · 2024Review
- Myocarditis, Myositis, and Myasthenia Gravis Overlap Syndrome Associated with Immune Checkpoint Inhibitors: A Systematic Review.Diagnostics (Basel, Switzerland) · 2024Review
- Management of overlapping immune-related myocarditis, myositis, and myasthenia in a young patient with advanced NSCLC: a case report.Frontiers in oncology · 2024Article
- Occult checkpoint inhibitor myocarditis during adjuvant nivolumab plus ipilimumab: a smoldering but severe toxicity.Immunotherapy · 2024Article
- Immune Checkpoint Inhibitors-Related Myocarditis: A Review of Reported Clinical Cases.Diagnostics (Basel, Switzerland) · 2023Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Immune checkpoint inhibitors targeting programmed cell death protein 1 and cytotoxic T-lymphocyte associated protein 4 have improved survival in patients with metastatic melanoma, especially in combination (i.e., ipilimumab-nivolumab). Postmarketing surveillance has identified rare but at times life-threatening adverse effects associated with these agents in combination and as monotherapy, which include myocarditis, myositis, myasthenia gravis (MG), and hepatotoxicity. Further evaluation of immune checkpoint therapy-induced MG identified the rapid clinical progression, prolonged treatment/supportive therapy course, and higher frequency of myasthenic crisis in these patients versus those with idiopathic MG. More rapid incorporation of aggressive treatment options (i.e., intravenous immunoglobulin, plasmapheresis) may be necessary in these cases. Anti-striational antibodies are often detected in individuals with myasthenia gravis and concurrent myositis and myocarditis. A high-index of suspicion is necessary to assist with rapid treatment initiation as these patients can rapidly deteriorate into respiratory compromise. A case of a 78-year-old woman with metastatic melanoma status after combination therapy with ipilimumab-nivolumab that developed transaminitis, myositis, myocarditis, and myasthenia gravis (with positive anti-striational antibodies) five days after the first cycle, is presented. Despite high dose intravenous methylprednisolone and intravenous immunoglobulin treatment, she ultimately entered hospice care eight days after hospital admission, 36 days after her first cycle.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.