Immune-related myocarditis with myositis and myasthenia gravis overlap syndrome induced by serplulimab
10.3760/cma.j.cn114015-20240318-00166
- VernacularTitle:斯鲁利单抗致免疫性心肌炎伴肌炎和重症肌无力重叠综合征
- Author:
Shujuan LIU
1
;
Wei CAI
;
Binbin YUAN
;
Xin LI
;
Feng SHAO
Author Information
1. 南京医科大学附属明基医院药学部，南京 210019
- Publication Type:Journal Article
- Keywords:
Myocarditis;
Myasthenia gravis;
Myositis;
Immune checkpoint inhibitors;
Serplulimab;
Immune-related adverse events
- From:
Adverse Drug Reactions Journal
2025;27(2):126-128
- CountryChina
- Language:Chinese
-
Abstract:
A 70-year-old female patient with tumor in the neck and body of the pancreas received 11 cycles of chemotherapy with paclitaxel and gemcitabine. Due to disease progression, she subsequently underwent chemotherapy of fluorouracil, calcium folinate, and irinotecan, combined with immunotherapy of serplulimab. After 28 days (only one session of immunotherapy), the patient developed drooping of the right upper eyelid and chest tightness, followed by pain in the middle and lower segments of the sternum and radiating pain to the throat, accompanied by speech difficulties, dysphagia, and chest tightness and wheezing. Laboratory tests indicated hypersensitive troponin T 0.551 μg/L, creatine kinase (CK) 3 426 U/L, CK-MB 176 μg/L, and myoglobin 1 702 μg/L. The imaging examination of head and neck ruled out intracranial lesions, while the electrocardiogram suggested myocardial damage. Immune-related myocarditis with myositis and/or myasthenia gravis overlap syndrome (IM3OS) induced by serplulimab was considered. Immunotherapy was temporarily halted, and treatments with methyprednisolone and human immunoglobulin were administered. Sixteen days later, clinical symptoms of IM3OS in the patient were improved, with laboratory tests showing hypersensitive troponin I 0.075 μg/L, CK 216 U/L, CK-MB 58 μg/L, and myoglobin 273 μg/L. Upon follow-up, the patient switched to monotherapy with irinotecan alone or combined with raltitrexed for cancer treatment, clinical symptoms of IM3OS did not recur, and no abnormalities were observed in myocardial injury markers or muscle enzymes.
