Myasthenia gravis: A rare neurologic complication of immune checkpoint inhibitor therapy Journal Article


Authors: Shames, Y.; Errante, M.; Prempeh Keteku, N.
Article Title: Myasthenia gravis: A rare neurologic complication of immune checkpoint inhibitor therapy
Abstract: Myasthenia gravis is an autoimmune disorder affecting the neuromuscular junction, which is characterized by the production of autoimmune antibodies to acetylcholine or muscle-specific kinase receptors, causing an error in transmission of nerve impulses to various muscles. The hallmark of myasthenia gravis is "grave or serious" fluctuating muscle weakness. Ocular, respiratory, bulbar, and skeletal muscles are most commonly affected; therefore, patients often present with fatigable ptosis, blurry vision, diplopia, change in facial expression, dysphagia, dysarthria, dyspnea, and limb weakness. Many medications, including fluroquinolone, aminoglycoside, magnesium sulfate, quinidine, and select beta blockers, are known to unmask or exacerbate symptoms of myasthenia gravis. Although the pathogenesis is not entirely understood, T lymphocytes are thought to play a role by blocking the acetylcholine receptors and causing antibody production. In the era of new immune-modulating therapies emerging for treatment of different cancers, their role in inducing a proinflammatory state has become apparent, thus highlighting a clear need to increase awareness about their role in inducing myasthenia gravis or myasthenia-like symptoms.
Keywords: aged; aged, 80 and over; neoplasms; inflammation; muscle weakness; autoantibodies; t lymphocytes; middle age; male; female; immunotherapy -- adverse effects; immune checkpoint inhibitors -- adverse effects; myasthenia gravis -- chemically induced; acetylcholine -- analogs and derivatives
Journal Title: Journal of the Advanced Practitioner in Oncology
Volume: 13
Issue: 2
ISSN: 2150-0878
Publisher: Harborside Press  
Date Published: 2022-03-01
Start Page: 151
End Page: 157
Language: English
PROVIDER: EBSCOhost
PROVIDER: cinahl
PMCID: PMC8955569
PUBMED: 35369395
DOI: 10.6004/jadpro.2022.13.2.6
DOI/URL:
Notes: Source: Cinahl
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  1. Yelena Shames
    12 Shames