Immune checkpoint inhibitor-related myocarditis, myositis, and myasthenia gravis overlap syndrome: a single-center case series and systematic review.
Jorge Soriano, Miguel Martínez-Rubiño, Miren Vicente Elcano et al.
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From the abstract
The aim of our study was to evaluate the clinical, diagnostic, therapeutic, and prognostic features of immune checkpoint inhibitor-related myocarditis, myositis, and myasthenia gravis overlap syndrome (IM3OS).
Reported results
In our series, all seven patients were male, with a median age of 81 years. The most frequent tumor types were non-small cell lung cancer (NSCLC) (42.8%) and urothelial carcinoma (28.5%). Diplopia (71.4%), ptosis (71.4%), and dyspnea (71.4%) were the most common presenting manifestations.
Authors' conclusions
IM3OS is a rare, early-onset, clinically severe immune-related overlap syndrome with a high mortality rate requiring prompt recognition, structured multisystem assessment, close cardiorespiratory monitoring, and multidisciplinary management. Current evidence remains observational and does not allow conclusions regarding therapeutic superiority.