BJMO - volume 18, issue 7, november 2024
Y. Vanbiervliet MD, H. Vandekerckhove MD, N. Van Tittelboom MA, V. Neyrinck MD, V. Renard MD, S. De Waele MA
This case report discusses a 76-year-old woman with a history of epilepsy and cerebral aneurysms who underwent surgical intervention for stage III malignant melanoma and subsequently received pembrolizumab as adjuvant immunotherapy. Four weeks post-treatment initiation, she presented with unilateral ptosis and was diagnosed with a complex immune-related adverse event involving myocarditis, myositis, and myasthenia gravis, termed the triple M syndrome. The patient exhibited elevated cardiac and muscular biomarkers, deranged liver enzymes, hypothyroidism, severe aortic valve insufficiency, and decreased systolic function. Comprehensive diagnostic assessments ruled out structural abnormalities and ischaemic disease, prompting the initiation of high-dose IV corticosteroids. The patient’s clinical course involved steroid resistance, necessitating an escalation of corticosteroids and the introduction of mycophenolic acid as second-line immunosuppressive therapy. A positive evolution was observed with a resolution of ptosis and improvement of cardiac biomarkers, including troponin levels, leading to successful discharge.
(BELG J MED ONCOL 2024;18(7):279–281)
Read more
Top
To provide the best experiences, we and our partners use technologies like cookies to store and/or access device information. Consenting to these technologies will allow us and our partners to process personal data such as browsing behavior or unique IDs on this site and show (non-) personalized ads. Not consenting or withdrawing consent, may adversely affect certain features and functions.
Click below to consent to the above or make granular choices. Your choices will be applied to this site only. You can change your settings at any time, including withdrawing your consent, by using the toggles on the Cookie Policy, or by clicking on the manage consent button at the bottom of the screen.
