Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case report

Immune checkpoint inhibitors, such as pembrolizumab, have demonstrated substantial therapeutic efficacy in the treatment of cancer. However, immune-related adverse events, including myasthenia gravis (MG), present significant clinical challenges. This study presents the case of a 75-year-old male pa...

Full description

Saved in:
Bibliographic Details
Main Authors: Ying Huang, Futian Wu, Yihan Xiong, Kangling Huang, Xin Chang, Xiaofeng Chen, Xiali Chen, Qiwen Zhang, Liangyu Zou, Xuejun Fu, Huadong Zhang, Qianhui Xu
Format: Article
Language:English
Published: SAGE Publishing 2025-04-01
Series:Therapeutic Advances in Neurological Disorders
Online Access:https://doi.org/10.1177/17562864251333518
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850174561348222976
author Ying Huang
Futian Wu
Yihan Xiong
Kangling Huang
Xin Chang
Xiaofeng Chen
Xiali Chen
Qiwen Zhang
Liangyu Zou
Xuejun Fu
Huadong Zhang
Qianhui Xu
author_facet Ying Huang
Futian Wu
Yihan Xiong
Kangling Huang
Xin Chang
Xiaofeng Chen
Xiali Chen
Qiwen Zhang
Liangyu Zou
Xuejun Fu
Huadong Zhang
Qianhui Xu
author_sort Ying Huang
collection DOAJ
description Immune checkpoint inhibitors, such as pembrolizumab, have demonstrated substantial therapeutic efficacy in the treatment of cancer. However, immune-related adverse events, including myasthenia gravis (MG), present significant clinical challenges. This study presents the case of a 75-year-old male patient who developed generalized acetylcholine receptor antibody-positive MG following the first infusion of pembrolizumab for cholangiocarcinoma. The patient’s symptoms rapidly progressed to an impending myasthenic crisis (MGFA Class IVB) within 20 days of pembrolizumab administration. Eculizumab was used as a rescue therapy due to the unavailability of conventional treatments, resulting in rapid and significant symptom relief, with sustained improvement during maintenance therapy. The use of eculizumab as rescue therapy presents a viable treatment option for pembrolizumab-induced MG, owing to its rapid therapeutic effects.
format Article
id doaj-art-5e6deab00a3b476d88601f51bacc92b4
institution OA Journals
issn 1756-2864
language English
publishDate 2025-04-01
publisher SAGE Publishing
record_format Article
series Therapeutic Advances in Neurological Disorders
spelling doaj-art-5e6deab00a3b476d88601f51bacc92b42025-08-20T02:19:38ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642025-04-011810.1177/17562864251333518Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case reportYing HuangFutian WuYihan XiongKangling HuangXin ChangXiaofeng ChenXiali ChenQiwen ZhangLiangyu ZouXuejun FuHuadong ZhangQianhui XuImmune checkpoint inhibitors, such as pembrolizumab, have demonstrated substantial therapeutic efficacy in the treatment of cancer. However, immune-related adverse events, including myasthenia gravis (MG), present significant clinical challenges. This study presents the case of a 75-year-old male patient who developed generalized acetylcholine receptor antibody-positive MG following the first infusion of pembrolizumab for cholangiocarcinoma. The patient’s symptoms rapidly progressed to an impending myasthenic crisis (MGFA Class IVB) within 20 days of pembrolizumab administration. Eculizumab was used as a rescue therapy due to the unavailability of conventional treatments, resulting in rapid and significant symptom relief, with sustained improvement during maintenance therapy. The use of eculizumab as rescue therapy presents a viable treatment option for pembrolizumab-induced MG, owing to its rapid therapeutic effects.https://doi.org/10.1177/17562864251333518
spellingShingle Ying Huang
Futian Wu
Yihan Xiong
Kangling Huang
Xin Chang
Xiaofeng Chen
Xiali Chen
Qiwen Zhang
Liangyu Zou
Xuejun Fu
Huadong Zhang
Qianhui Xu
Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case report
Therapeutic Advances in Neurological Disorders
title Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case report
title_full Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case report
title_fullStr Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case report
title_full_unstemmed Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case report
title_short Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case report
title_sort eculizumab as fast acting rescue therapy for pembrolizumab induced impending crisis state of myasthenia gravis a case report
url https://doi.org/10.1177/17562864251333518
work_keys_str_mv AT yinghuang eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT futianwu eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT yihanxiong eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT kanglinghuang eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT xinchang eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT xiaofengchen eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT xialichen eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT qiwenzhang eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT liangyuzou eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT xuejunfu eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT huadongzhang eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport
AT qianhuixu eculizumabasfastactingrescuetherapyforpembrolizumabinducedimpendingcrisisstateofmyastheniagravisacasereport