中国药物警戒 ›› 2026, Vol. 23 ›› Issue (5): 569-571.
DOI: 10.19803/j.1672-8629.20250832

• 安全与合理用药 • 上一篇    下一篇

特瑞普利单抗注射液致免疫检查点抑制剂相关重症肌无力合并急性心肌炎1例分析

邹蕊, 吴雨桐, 周玥, 李琴, 孟召友*   

  1. 陆军军医大学第二附属医院神经内科,重庆 400037
  • 收稿日期:2025-11-20 发布日期:2026-05-20
  • 通讯作者: *孟召友,男,博士,副主任医师,神经免疫性疾病基础与临床研究。E-mail: mengzhaoyou@tmmu.edu.cn
  • 作者简介:邹蕊,女,本科,护师,神经内科临床与基础研究。
  • 基金资助:
    国家自然科学基金资助项目（82171342）

One Case of Myasthenia Gravis with Acute Myocarditis Caused by Toripalimab Injection

ZOU Rui, WU Yutong, ZHOU Yue, LI Qin, MENG Zhaoyou*   

  1. Department of Neurology, the Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
  • Received:2025-11-20 Published:2026-05-20

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摘要： 目的 探讨特瑞普利单抗注射液诱发免疫检查点抑制剂相关重症肌无力（Myasthenia Gravis,MG）合并急性心肌炎的临床特征、关联性及治疗策略,为临床安全用药提供参考。方法 分析1例肾透明细胞癌患者接受特瑞普利单抗注射液治疗后出现MG及急性心肌炎的完整诊疗过程,判断不良反应关联性,检索相关文献,探讨其发生机制、临床特点及干预要点。结果 经2种关联性评价方法均判定为“很可能”。停用特瑞普利单抗注射液后,予甲泼尼龙静脉冲击,免疫球蛋白静脉滴注,他克莫司、溴吡斯的明口服治疗,症状完全缓解,随访6个月无复发。结论 特瑞普利单抗注射液诱发的免疫检查点抑制剂相关MG合并急性心肌炎属罕见但致命的免疫相关不良反应,用药期间需加强监测,早期识别并及时干预可改善预后。

关键词: 特瑞普利单抗注射液, 免疫检查点抑制剂, 重症肌无力, 急性心肌炎, 药品不良反应

Abstract: Objective To investigate the clinical features, causality, and management strategies of myasthenia gravis (MG) combined with acute myocarditis induced by toripalimab injection so as to provide references for safe clinical use of the drug. Methods The diagnosis and treatment process of a patient with clear cell renal cell carcinoma (ccRCC) who developed MG and acute myocarditis after receiving toripalimab injection was analyzed. The correlation of adverse reactions was determined, related literature was reviewed, and the pathogenesis, clinical features, and major interve-ntions were discussed. Results Both causality assessment tools indicated a “probable” association. Upon discontinuation of toripalimab, the patient received methylprednisolone pulse therapy, intravenous immunoglobulin, tacrolimus, and pyridos-tigmine, leading to complete symptom resolution. There was no recurrence during the 6-month follow-up. Conclusion MG combined with acute myocarditis induced by toripalimab injection is a rare but fatal immune-related adverse events (irAEs). Monitoring is required during medication. Early identification and quick interventions can improve prognosis.

Key words: Toripalimab Injection, Immune Checkpoint Inhibitor, Myasthenia Gravis (MG), Acute Myocarditis, Adverse Drug Reaction

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