Evidence map›Paper›PMID 34691341›Full record

ArticleJournal of medical cases2021

Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis.

Nayha Tahir, Anber Mahboob, Xuanzhen Piao, Grace Ying, Jishna Shrestha, Robin Sherchan, Farha Zahra

Open access · diamondAbstract readCase Reports
In one paragraph

Article in Journal of medical cases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Nayha TahirChicago Medical School, Rosalind Franklin University of Medicine and Science, Internal Medicine Residency Program at Northwestern Medicine Hospital, McHenry, IL, USA.
Anber MahboobSharif Medical and Dental College, Lahore, Pakistan.
Xuanzhen PiaoChicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Grace YingChicago Medical School, Rosalind Franklin University of Medicine and Science, Internal Medicine Residency Program at Northwestern Medicine Hospital, McHenry, IL, USA.
Jishna ShresthaChicago Medical School, Rosalind Franklin University of Medicine and Science, Internal Medicine Residency Program at Northwestern Medicine Hospital, McHenry, IL, USA.
Robin SherchanChicago Medical School, Rosalind Franklin University of Medicine and Science, Internal Medicine Residency Program at Northwestern Medicine Hospital, McHenry, IL, USA.
Farha ZahraDepartment of Internal Medicine, Northwestern Medicine McHenry Hospital, McHenry, IL, USA.
Northwestern Medicine · USRosalind Franklin University of Medicine and Science · USCMH Lahore Medical College and Institute of Dentistry · PK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Nivolumab is a checkpoint inhibitor approved to treat various solid organs malignancies. Although checkpoint inhibitors are very efficacious, these medications are also associated with a variety of side effects that could be life-threatening. We present a case of nivolumab-induced myasthenia gravis in a patient with stage IV esophageal cancer, who was found to have generalized weakness, blurry vision, diplopia, and later developed acute hypoxic respiratory failure with subsequent intubation. The patient was treated with intravenous immunoglobulin and plasmapheresis, and later started on pyridostigmine and high-dose steroids with minimal improvement. Goals of care were discussed with the patient and family, and the decision was made to discharge the patient home with hospice care. Nivolumab-induced myasthenia gravis is very aggressive with a poor prognosis if not appropriately managed in time. Hence we strongly recommend a multidisciplinary approach, including neurologists, to monitor patients on nivolumab therapy to reduce morbidity and mortality associated with it.

Indexed as

Esophageal cancerMyasthenia gravisNivolumabPD-L1 inhibitors

Identifiers

PMID34691341
PMCPMC8510662
OpenAlexW3202959831

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.