{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T23:54:30Z","timestamp":1778889270713,"version":"3.51.4"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"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":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Immune checkpoint inhibitors are a relatively new advancement in the world of cancer therapy. As such, their adverse effects have yet to be fully understood, with only recent literature documenting autoimmune phenomena secondary to their utilization. Specific immune checkpoint inhibitors have recently been linked with the development of myasthenia gravis, which is classically known to manifest spontaneously in patients. Given the relative rarity of this presentation, the risk of misdiagnosis and subsequent mortality and morbidity is concerning.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We discuss the case of a 73-year-old male who presented with clinical symptoms of myasthenia gravis and myositis shortly after beginning treatment with Pembrolizumab. The diagnosis of myasthenia gravis was initially missed at an outside hospital, which delayed initiation of proper treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>While the incidence of \u201c<jats:italic>de-novo\u201d<\/jats:italic> diseases secondary to immune checkpoint inhibitors might be increasing, guidelines regarding best treatment options do not yet exist, leaving many providers at a loss when faced with making clinical decisions surrounding patients with De novo myasthenia gravis. Thus, our goal is to underscore the importance of early recognition of this disease, and emphasize the need for a standard of care as immune checkpoint inhibitors usage becomes more prevalent.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12883-024-03684-2","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T05:01:54Z","timestamp":1717218114000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Spontaneous development of myasthenia gravis and myositis following treatment with pembrolizumab: a case report"],"prefix":"10.1186","volume":"24","author":[{"given":"Benjamin","family":"Kiaei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maaria","family":"Chaudhry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumona","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Brewer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongzhen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farid","family":"Khasiyev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel A.","family":"Guzman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghazala","family":"Hayat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,1]]},"reference":[{"issue":"4","key":"3684_CR1","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1080\/14740338.2020.1738382","volume":"19","author":"AM Haugh","year":"2020","unstructured":"Haugh AM, Probasco JC, Johnson DB. Neurologic complications of immune checkpoint inhibitors. Expert Opin Drug Saf. 2020;19(4):479\u201388. https:\/\/doi.org\/10.1080\/14740338.2020.1738382. Epub 2020 Mar 11. PMID: 32126176; PMCID: PMC7192781.","journal-title":"Expert Opin Drug Saf"},{"issue":"3","key":"3684_CR2","doi-asserted-by":"publisher","first-page":"e223461","DOI":"10.1001\/jamanetworkopen.2022.3461","volume":"5","author":"SJ Schonfeld","year":"2022","unstructured":"Schonfeld SJ, Tucker MA, Engels EA, et al. Immune-related adverse events after immune checkpoint inhibitors for Melanoma among older adults. JAMA Netw Open. 2022;5(3):e223461. https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.3461.","journal-title":"JAMA Netw Open"},{"issue":"5","key":"3684_CR3","doi-asserted-by":"publisher","first-page":"989","DOI":"10.3390\/cancers13050989","volume":"13","author":"HJ Albandar","year":"2021","unstructured":"Albandar HJ, Fuqua J, Albandar JM, Safi S, Merrill SA, Ma PC. Immune-related adverse events (irAE) in cancer immune checkpoint inhibitors (ICI) and survival outcomes correlation: to rechallenge or not? Cancers (Basel). 2021;13(5):989. https:\/\/doi.org\/10.3390\/cancers13050989. PMID: 33673446; PMCID: PMC7956829.","journal-title":"Cancers (Basel)"},{"issue":"1","key":"3684_CR4","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1186\/s40425-019-0774-y","volume":"7","author":"H Safa","year":"2019","unstructured":"Safa H, Johnson DH, Trinh VA, Rodgers TE, Lin H, Suarez-Almazor ME, et al. Immune checkpoint inhibitor related myasthenia gravis: single center experience and systematic review of the literature. J Immunother Cancer. 2019;7(1):319. https:\/\/doi.org\/10.1186\/s40425-019-0774-y. PMID: 31753014; PMCID: PMC6868691.","journal-title":"J Immunother Cancer"},{"key":"3684_CR5","doi-asserted-by":"publisher","first-page":"634","DOI":"10.3389\/fneur.2020.00634","volume":"11","author":"YT Huang","year":"2020","unstructured":"Huang YT, Chen YP, Lin WC, Su WC, Sun YT. Immune checkpoint inhibitor-induced Myasthenia Gravis. Front Neurol. 2020;11:634. https:\/\/doi.org\/10.3389\/fneur.2020.00634. PMID: 32765397; PMCID: PMC7378376.","journal-title":"Front Neurol"},{"issue":"1","key":"3684_CR6","doi-asserted-by":"publisher","first-page":"130","DOI":"10.3390\/jcm12010130","volume":"12","author":"C Marco","year":"2022","unstructured":"Marco C, Sim\u00f3 M, Alemany M, Casasnovas C, Dom\u00ednguez R, Vilari\u00f1o N, Calvo M, Mart\u00edn-Liberal J, Brenes J, Sabater-Riera J, Bruna J, Velasco R. Myasthenia gravis induced by immune checkpoint inhibitors: an emerging neurotoxicity in Neuro-Oncology practice: Case Series. J Clin Med. 2022;12(1):130. https:\/\/doi.org\/10.3390\/jcm12010130. PMID: 36614930; PMCID: PMC9821391.","journal-title":"J Clin Med"},{"key":"3684_CR7","doi-asserted-by":"publisher","first-page":"779691","DOI":"10.3389\/fimmu.2022.779691","volume":"13","author":"A Chennamadhavuni","year":"2022","unstructured":"Chennamadhavuni A, Abushahin L, Jin N, Presley CJ, Manne A. Risk factors and biomarkers for Immune-related adverse events: a practical guide to identifying high-risk patients and rechallenging immune checkpoint inhibitors. Front Immunol. 2022;13:779691. https:\/\/doi.org\/10.3389\/fimmu.2022.779691. PMID: 35558065; PMCID: PMC9086893.","journal-title":"Front Immunol"},{"key":"3684_CR8","doi-asserted-by":"publisher","first-page":"730","DOI":"10.3389\/fphar.2017.00730","volume":"8","author":"PF Wang","year":"2017","unstructured":"Wang PF, Chen Y, Song SY, Wang TJ, Ji WJ, Li SW, Liu N, Yan CX. Immune-related adverse events Associated with Anti-PD-1\/PD-L1 treatment for malignancies: a Meta-analysis. Front Pharmacol. 2017;8:730. https:\/\/doi.org\/10.3389\/fphar.2017.00730. PMID: 29093678; PMCID: PMC5651530.","journal-title":"Front Pharmacol"},{"issue":"8","key":"3684_CR9","doi-asserted-by":"publisher","first-page":"e243764","DOI":"10.1136\/bcr-2021-243764","volume":"14","author":"B Hajihossainlou","year":"2021","unstructured":"Hajihossainlou B, Vasileva A, Manthri S, Chakraborty K. Myasthenia gravis induced or exacerbated by immune checkpoint inhibitors: a rising concern. BMJ Case Rep. 2021;14(8):e243764. https:\/\/doi.org\/10.1136\/bcr-2021-243764. PMID: 34426425; PMCID: PMC8383870.","journal-title":"BMJ Case Rep"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-024-03684-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-024-03684-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-024-03684-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T05:02:59Z","timestamp":1717218179000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcneurol.biomedcentral.com\/articles\/10.1186\/s12883-024-03684-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,1]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3684"],"URL":"https:\/\/doi.org\/10.1186\/s12883-024-03684-2","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,1]]},"assertion":[{"value":"14 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained for publication of clinical details from the patient; these details are de-identified.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"184"}}