Postoperative Neuromuscular Paresis and Overlap Syndrome Related to Immune Checkpoint Inhibitors: A Case Report.

JBJS Case ConnectNov 5, 2026 (epub)
Case ReportOncology (Medical)NeurologyCardiologyPulmonology

Barlas Goker, Ilem Karaca, Andrew Johns et al.

✦ AI-curated · Sources linked

Case in brief

A patient receiving immune checkpoint inhibitor therapy developed extremity paresis after proximal humerus resection and reconstruction. The presentation was attributed to immune checkpoint inhibitor–related overlap syndrome involving myositis, myocarditis, and myasthenia gravis. The course was complicated by respiratory failure and septic shock, requiring intensive care. Treatment with intravenous immunoglobulin, corticosteroids, and plasmapheresis was followed by gradual recovery.

What made this case unusual

The 3M overlap syndrome presented postoperatively with extremity paresis after proximal humerus resection and reconstruction.

Diagnostic / clinical pearl

In a patient treated with immune checkpoint inhibitors, new postoperative paresis should prompt consideration of overlapping myositis, myocarditis, and myasthenia gravis, particularly if respiratory failure develops.

Source

PubMed · PMID 42987229

Published in JBJS Case Connect. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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