| Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc |
| Journal website https://www.journalmc.org |
Case Report
Volume 12, Number 10, October 2021, pages 424-428
Nivolumab, a Double-Edged Sword: A Case Report of Nivolumab-Induced Myasthenia Gravis
Tables
| Variables | Day 1 | Day 5 | Day 9 | Day 13 | Day of discharge |
|---|---|---|---|---|---|
| WBC: white blood cell; NV: normal value; BUN: blood urea nitrogen; N/A: not applicable. | |||||
| WBC (NV: 4.1 - 11.0 × 103/µL) | 10.6 | 5.1 | 9.9 | 5.5 | 6.9 |
| Neutrophils (NV: 2.1 - 8.4 × 103/µL) | 8.8 | 4.4 | 8.4 | 4.2 | 5.1 |
| Hemoglobin (NV: 12.0 - 16.0 g/dL) | 8.0 | 7.7 | 7.5 | 8.6 | 11.2 |
| Platelet (NV: 150 - 400 × 103/µL) | 130 | 89 | 82 | 109 | 115 |
| BUN (NV: 8 - 24 mg/dL) | 30 | 25 | 60 | 51 | 48 |
| Creatinine (NV: 0.55 - 1.30 mg/dL) | 1.14 | 0.92 | 0.86 | 0.78 | 0.65 |
| Fibrinogen (NV: 200 - 400 mg/dL) | N/A | 165 | 171 | 203 | 199 |
| Arterial blood pH (NV: 7.38 - 7.42) | 7.42 | 7.40 | 7.47 | 7.47 | N/A |
| Results | |
|---|---|
| Titin antibody (reference: < 11 SI) | 91 |
| Striated muscle antibody | Positive |
| Striated muscle antibody titer (reference: < 1:40) | 1:160 |
| Acetylcholine receptor modulating antibody (reference: < 32% inhibition) | < 6% |
| Acetylcholine receptor blocking antibody (reference: < 15% inhibition) | < 15% |
| Acetylcholine receptor binding antibody | < 0.30 |
| Negative: ≤ 0.30 nmol/L | |
| Equivocal: 0.31 - 0.49 nmol/L | |
| Positive: ≥ 0.50 nmol/L | |
| Autoimmune comprehensive neurology antibody panel | Negative |