{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:37:20Z","timestamp":1793407040341,"version":"4.5.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Myasthenia gravis (MG) is an autoimmune neuromuscular disease whose treatment encompasses acetylcholinesterase inhibitors, oral steroids, and other immunosuppressants. Kaposi\u2019s sarcoma (KS) is a lymphangioproliferative disease associated with human herpesvirus 8 (HHV-8) infection and immunodeficiency or immunosuppression, mainly corticosteroids.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case reports<\/jats:title>\n                <jats:p>We present two cases of MG patients treated with oral steroids who developed KS. Patient 1 was diagnosed with three oral KS lesions. Prednisone was discontinued with lesion regression and stabilization, while azathioprine and pyridostigmine prompted control of MG. Patient 2 developed KS lesions on the trunk and lower limbs while taking prednisone and azathioprine. Steroid tapering was started but new oral and lymph nodal lesions appeared. Paclitaxel therapy was introduced and the patient experienced pulmonary embolism and developed sensitive neuropathy. Complete remission of KS lesions was achieved and maintained with azathioprine and pyridostigmine as MG medications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>KS is an uncommon but clinically relevant adverse event (AE) often induced by steroid therapy. It can be controlled by steroid withdrawal but could necessitate chemotherapy, which associates with further potential AEs. Skin evaluation should be performed in all patients with chronic steroid therapy. Steroid-sparing strategies, including new drugs, could reduce KS and other steroid-related comorbidities. HHV-8 testing should be considered before starting chronic immunosuppression.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10072-020-04971-9","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T12:03:35Z","timestamp":1609934615000},"page":"2081-2083","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Iatrogenic Kaposi\u2019s sarcoma in myasthenia gravis: learnings from two case reports"],"prefix":"10.1007","volume":"42","author":[{"given":"Rita","family":"Frangiamore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7352-9445","authenticated-orcid":false,"given":"Riccardo","family":"Giossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiammetta","family":"Vanoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasia","family":"Tourlaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Brambilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0932-5173","authenticated-orcid":false,"given":"Lorenzo","family":"Maggi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9810-5737","authenticated-orcid":false,"given":"Renato","family":"Mantegazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,6]]},"reference":[{"key":"4971_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41572-018-0051-2","volume":"5","author":"NE Gilhus","year":"2019","unstructured":"Gilhus NE, Tzartos S, Evoli A et al (2019) Myasthenia gravis. Nat Rev Dis Prim 5:1\u201319","journal-title":"Nat Rev Dis Prim"},{"key":"4971_CR2","doi-asserted-by":"publisher","unstructured":"Brambilla L, Tourlaki A, Genovese G (2017) Iatrogenic Kaposi\u2019s sarcoma: a retrospective cohort study in an Italian tertiary care centre. Clin Oncol 29:e165\u2013e171. https:\/\/doi.org\/10.1016\/j.clon.2017.05.008","DOI":"10.1016\/j.clon.2017.05.008"},{"key":"4971_CR3","doi-asserted-by":"publisher","unstructured":"Brambilla L, Genovese G, Berti E, Peris K, Rongioletti F, Micali G, Ayala F, Della Bella S, Mancuso R, Calzavara Pinton P, Tourlaki A (2020) Italian guidelines for the diagnosis and treatment of classic and iatrogenic Kaposi's sarcoma. G Ital Dermatol Venereol. https:\/\/doi.org\/10.23736\/S0392-0488.20.06703-6","DOI":"10.23736\/S0392-0488.20.06703-6"},{"key":"4971_CR4","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1111\/ced.13151","volume":"42","author":"L Brambilla","year":"2017","unstructured":"Brambilla L, Esposito L, Nazzaro G, Tourlaki A (2017) Onset of Kaposi sarcoma and Merkel cell carcinoma during low-dose steroid therapy for rheumatic polymyalgia. Clin Exp Dermatol 42:702\u2013704. https:\/\/doi.org\/10.1111\/ced.13151","journal-title":"Clin Exp Dermatol"},{"key":"4971_CR5","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1093\/rheumatology\/39.11.1294","volume":"39","author":"T Vincent","year":"2000","unstructured":"Vincent T, Moss K, Colaco B, Venables PJW (2000) Kaposi\u2019s sarcoma in two patients following low-dose corticosteroid treatment for rheumatological disease. Rheumatology 39:1294\u20131296. https:\/\/doi.org\/10.1093\/rheumatology\/39.11.1294","journal-title":"Rheumatology"},{"key":"4971_CR6","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1007\/s10072-019-03746-1","volume":"40","author":"A Evoli","year":"2019","unstructured":"Evoli A, Antonini G, Antozzi C, DiMuzio A, Habetswallner F, Iani C, Inghilleri M, Liguori R, Mantegazza R, Massa R, Pegoraro E, Ricciardi R, Rodolico C (2019) Italian recommendations for the diagnosis and treatment of myasthenia gravis. Neurol Sci 40:1111\u20131124. https:\/\/doi.org\/10.1007\/s10072-019-03746-1","journal-title":"Neurol Sci"},{"key":"4971_CR7","doi-asserted-by":"publisher","first-page":"4178","DOI":"10.3390\/v6114178","volume":"6","author":"V Minhas","year":"2014","unstructured":"Minhas V, Wood C (2014) Epidemiology and transmission of Kaposi\u2019s sarcoma-associated herpesvirus. Viruses 6:4178\u20134194. https:\/\/doi.org\/10.3390\/v6114178","journal-title":"Viruses"},{"key":"4971_CR8","doi-asserted-by":"publisher","first-page":"3165","DOI":"10.1172\/JCI84418","volume":"126","author":"DP Dittmer","year":"2016","unstructured":"Dittmer DP, Damania B (2016) Kaposi sarcoma-associated herpesvirus: immunobiology, oncogenesis, and therapy. J Clin Invest 126:3165\u20133175. https:\/\/doi.org\/10.1172\/JCI84418","journal-title":"J Clin Invest"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-020-04971-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-020-04971-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-020-04971-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T06:18:19Z","timestamp":1618294699000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-020-04971-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,6]]},"references-count":8,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["4971"],"URL":"https:\/\/doi.org\/10.1007\/s10072-020-04971-9","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,6]]},"assertion":[{"value":"13 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 December 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"R.F. received support for congress participations from Argenx, Biogen, Catalyst, Merck, Momenta, Novartis, and Sanofi Genzyme. R.G. received support for congress participation from Mylan. F.V. received support for congress participations from Biogen, Kedrion, and Sanofi Genzyme. A.T. reports no competing interest. L.B. reports no competing interest. L.M. received honoraria for speaking and compensation for congress participations from Biogen and Sanofi Genzyme. R.M. received fees and honoraria for meeting, travel, and advisory board from Alexion, Argenx, Biomarin, Catalyst, Merck Serono, UCB.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The Ethics Committee of Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta requires the patient consent for case reports publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent for publication was received by the patients for the usage of anonymized clinical data and images.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}