{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:56:34Z","timestamp":1790103394956,"version":"4.0.1"},"reference-count":7,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Herein, we report the case of a 48\u2010year\u2010old woman with metastatic thymoma who developed fulminant myositis with cardiotoxicity after one cycle of pembrolizumab treatment. She presented with severe muscle weakness and dyspnea, and her laboratory test results revealed increased muscle and cardiac enzyme levels. Despite an urgent initiation of systemic steroids, her muscle weakness and hypercapnia worsened, for which intravenous immunoglobulin G was initiated. However, hypercapnia did not improve, but the patient recovered completely after plasma exchange. Patients with thymic neoplasms could be susceptible to fulminant forms of immune\u2010related adverse effects because they lack normal thymic physiology. Clinicians must not hesitate to consider immunoglobulin G administration and plasma exchange therapy as the next treatment steps for steroid\u2010refractory patients.<\/jats:p>","DOI":"10.1002\/rcr2.1025","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:14:21Z","timestamp":1661386461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Early development of pembrolizumab\u2010induced fulminant myositis and cardiotoxicity in a patient with metastatic thymoma"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3954-1894","authenticated-orcid":false,"given":"Soo Yeon","family":"Jang","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine Korea University Guro Hospital, Korea University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8693-5792","authenticated-orcid":false,"given":"Sung Yong","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine Korea University Guro Hospital, Korea University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9800-3263","authenticated-orcid":false,"given":"Hye Lim","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology Korea University Guro Hospital, Korea University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6536-9763","authenticated-orcid":false,"given":"Juwhan","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine Korea University Guro Hospital, Korea University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000391"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2217\/lmt-2018-0017"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.09.033"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2017.08.005"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/med.2019.08.02"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1703481"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.4110\/in.2020.20.e9"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.1025","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.1025","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.1025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T17:46:06Z","timestamp":1692726366000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.1025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,24]]},"references-count":7,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1002\/rcr2.1025"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.1025","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,24]]},"assertion":[{"value":"2022-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01025"}}