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Consider Myocarditis When Patients Treated with Immune Checkpoint Inhibitors Present with Ocular Symptoms
John Y Rhee1,2, Nurhan Torun3, Tomas G Neilan4
1Mass General Brigham, Department of Neurology, Harvard Medical School, Boston, MA, USA.
Abstract:
Immune checkpoint inhibitors (ICIs) have been associated with neurological immune related adverse events (irAE-N) and patients with ICI toxicity may present with neurological or ocular symptoms. Furthermore, patients on ICI may initially present to oncology or neurology. We report a case series of 3 patients treated with ICIs presenting with diplopia or ptosis, found to have concurrent myocarditis in addition to immune-related myopathy (irMyopathy) or myasthenia gravis (irMG). None of the patients described cardiac symptoms, underscoring the importance of screening for myocarditis in patients presenting with diplopia and/or other neuromuscular symptoms which may suggest either irMyopathy or irMG.
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