BRAIN and NERVE－神経研究の進歩76巻1号

2024年01月発行

特集 新時代の重症筋無力症と関連疾患の診療

irAEとして発症する重症筋無力症の臨床像

著者： 鈴木重明¹

所属機関： ¹慶應義塾大学医学部神経内科

ページ範囲：P.27 - P.32

文献概要

免疫チェックポイント阻害薬に関連した免疫関連有害事象として発症する神経・筋障害は多彩である。特に重要なのが，重症筋無力症（irAE-MG）であり投与早期に発症し，頻度は1％程度である。急速に進行し球症状やクリーゼを伴う重症例が多く，血清クレアチンキナーゼが高値であり筋炎の特徴を併せ持つ。致死的な心筋炎を合併する場合があり，Kv1.4抗体がバイオマーカーとなる。ステロイドなど免疫療法が有効で，早急に開始する必要がある。

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