ArticleCureus2024
Immune Checkpoint Inhibitor-Induced Myositis Causing Severe Ptosis: A Case Report.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pembrolizumab (Keytruda), an immune checkpoint inhibitor, has been increasingly utilized in the treatment of metastatic urothelial carcinoma. While offering a favorable safety profile compared to traditional chemotherapy, it presents unique risks, including immune-related adverse events (irAEs). This case report describes a 77-year-old woman with a history of invasive bladder cancer treated with pembrolizumab who developed severe bilateral ptosis, myositis, and myocarditis. Initially considered to have 3M syndrome, further evaluation indicated a myasthenia gravis mimic. This report emphasizes the critical need for vigilant monitoring for early signs of irAEs, such as ptosis, myocarditis, and myositis, in patients receiving pembrolizumab. The patient presented with severe ptosis and respiratory difficulties and was successfully treated with high-dose steroids and plasma exchange therapy, leading to overall improvement. This case highlights the diagnostic challenges of differentiating myositis from myasthenia gravis in patients with ICI-induced complications while advocating for an aggressive treatment approach.
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