Nivolumab-induced Myositis and Myocarditis with Positive Anti-titin Antibody and Anti-voltage-gated Potassium Channel Kv1.4 Antibody

Intern Med. 2022 Oct 1;61(19):2973-2979. doi: 10.2169/internalmedicine.8772-21. Epub 2022 Mar 19.

Abstract

Immune checkpoint inhibitors (ICIs) are complicated by immune-related adverse events (irAEs), such as myositis, myocarditis, and myasthenia gravis (MG). Anti-titin antibody and anti-voltage-gated potassium channel Kv1.4 antibody are anti-striated antibodies that are frequently detected in MG patients with myositis and/or myocarditis. However, the clinical relationship between positive anti-striated antibodies and irAEs of ICIs remains unknown. We herein report a case of nivolumab-induced myositis and myocarditis with positive anti-titin antibody and anti-voltage-gated potassium channel Kv1.4 antibody in a patient with non-small-cell lung cancer. We also review reported cases of positive anti-striated antibodies related to irAEs of ICIs.

Keywords: anti-striated antibody; anti-titin antibody; anti-voltage-gated potassium channel Kv1.4 antibody; immune checkpoint inhibitors; immune-related adverse events; nivolumab.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies / adverse effects
  • Carcinoma, Non-Small-Cell Lung* / complications
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Myasthenia Gravis* / complications
  • Myocarditis* / chemically induced
  • Myocarditis* / complications
  • Myocarditis* / diagnosis
  • Myositis* / chemically induced
  • Myositis* / complications
  • Myositis* / diagnosis
  • Nivolumab / adverse effects
  • Potassium Channels, Voltage-Gated*

Substances

  • Autoantibodies
  • Immune Checkpoint Inhibitors
  • Potassium Channels, Voltage-Gated
  • Nivolumab