一例免疫检查点抑制剂相关的重症肌无力及艾加莫德治疗

Objective To investigate the clinical characteristics of immune checkpoint inhibitor associated myasthenia gravis (ICIs-MG) and the therapeutic efficacy of efgartigimod, providing reference for clinical practice. Methods A retrospective analysis was conducted on the clinical data of a patient with immune checkpoint inhibitor associated myasthenia gravis treated at Yulin First Hospital. Results The patient was an elderly male with a history of immune checkpoint inhibitor use, presented with typical symptoms of myasthenia gravis and was diagnosed with immune checkpoint inhibitor associated myasthenia gravis. After admission, immune checkpoint inhibitors were discontinued, and treatment with methylprednisolone succinate and intravenous immunoglobulin was initiated. However, the symptoms of dyspnea did not significantly improve. Improvement in ptosis was observed after the administration of pyridostigmine bromide. Following discussion with the patient and family, efgartigimod was introduced, with corticosteroid dosage tapered gradually according to guidelines and the patient’ s condition. After treatment,the patient’ s symptoms of dyspnea and other related symptoms gradually improved, and relevant laboratory indicators significantly decreased. The patient continued the same treatment regimen after discharge. A follow-up examination two weeks later revealed no recurrence of myasthenia gravis symptoms, and the rechecked indicators were essentially normal. Conclusion Immune checkpoint inhibitor associated myasthenia gravis is a rare clinical condition characterized by severe and rapidly progressive disease, with a high mortality rate. Early diagnosis and prompt treatment are crucial.This case is reported here to provide a reference for the clinical management of similar cases.