{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:38:17Z","timestamp":1791005897550,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T00:00:00Z","timestamp":1717977600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Key Clinical Message<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors can rarely lead to occurrence of myositis, myocarditis, and myasthenia gravis (MG). Early recognition and multidisciplinary management are crucial for optimal outcomes. Vigilance for overlapping toxicities is essential in patients receiving combination immunotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>The use of immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment, but it is associated with immune\u2010related adverse events (IRAEs) affecting various organ systems. The simultaneous occurrence of MG, myocarditis, and myositis highlights the complex nature of IRAEs. Early recognition and comprehensive multidisciplinary management are crucial for optimal patient outcomes. We present a unique case report of a 76\u2010year\u2010old male patient with advanced melanoma who developed concurrent myositis, myocarditis, and MG while receiving combination immunotherapy with Nivolumab and Ipilimumab. This case underscores the significance of recognizing and addressing the \u201cTerrible Triad\u201d of IRAEs in patients receiving ICIs. Healthcare providers should maintain a high index of suspicion for overlapping toxicities and promptly initiate appropriate interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccr3.8968","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T23:45:55Z","timestamp":1718063155000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Immune checkpoint inhibitor\u2010induced myasthenia gravis, myocarditis, and myositis: A case report"],"prefix":"10.1002","volume":"12","author":[{"given":"Arjun","family":"Basnet","sequence":"first","affiliation":[{"name":"Maimonides Medical Center  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6859-7710","authenticated-orcid":false,"given":"Nava Raj","family":"Sharma","sequence":"additional","affiliation":[{"name":"Manipal College of Medical Sciences  Pokhara Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudarshan","family":"Gautam","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6165-5452","authenticated-orcid":false,"given":"Saral","family":"Lamichhane","sequence":"additional","affiliation":[{"name":"Gandaki Medical College  Pokhara Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajog","family":"Kansakar","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kripa","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalasa","family":"Pokhrel","sequence":"additional","affiliation":[{"name":"Montefiore New Rochelle Hospital  New Rochelle New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sehajpreet","family":"Singh","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,10]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30533-6"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1609214"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-018-0878-7"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10555-021-09976-0"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.12180"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.6385"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013757"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40959-021-00114-x"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006124"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30608-9"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/onco.13931"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872620910109"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.8968","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T02:48:59Z","timestamp":1720666139000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.8968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/ccr3.8968"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.8968","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.168655502.27616350\/v1","asserted-by":"object"}]},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6]]},"assertion":[{"value":"2023-06-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e8968"}}