Annals of Clinical and Translational Neurology (May 2023)

Clinicoserological insights into patients with immune checkpoint inhibitor‐induced myasthenia gravis

  • Gianvito Masi,
  • Minh C. Pham,
  • Tabitha Karatz,
  • Sangwook Oh,
  • Aimee S. Payne,
  • Richard J. Nowak,
  • James F. Howard Jr,
  • Jeffrey T. Guptill,
  • Vern C. Juel,
  • Kevin C. O'Connor

DOI
https://doi.org/10.1002/acn3.51761
Journal volume & issue
Vol. 10, no. 5
pp. 825 – 831

Abstract

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Abstract To compare the immunopathology of immune checkpoint inhibitor‐induced myasthenia gravis (ICI‐MG) and idiopathic MG, we profiled the respective AChR autoantibody pathogenic properties. Of three ICI‐MG patients with AChR autoantibodies, only one showed complement activation and modulation/blocking potency, resembling idiopathic MG. In contrast, AChR autoantibody‐mediated effector functions were not detected in the other two patients, questioning the role of their AChR autoantibodies as key mediators of pathology. The contrasting properties of AChR autoantibodies in these cases challenge the accuracy of serological testing in establishing definite ICI‐MG diagnoses and underscore the importance of a thorough clinical assessment when evaluating ICI‐related adverse events.