Clinical Scorecard: Eculizumab as an Effective Rescue Treatment for Likely Tislelizumab-Induced MMM Overlap Syndrome with Coexisting Anti-Acetylcholine Receptor and Anti-Titin Antibodies: A Case Study and Review of Existing Literature

At a Glance

Key Highlights

• Eculizumab demonstrated rapid clinical improvement in a patient with tislelizumab-related MMM overlap syndrome.
• The patient exhibited dual positivity for anti-AChR and anti-titin antibodies.
• Conventional treatments like corticosteroids and IVIG were initially ineffective.
• ICI-MMM has a high mortality rate, emphasizing the need for effective rescue therapies.
• This case suggests eculizumab may be a promising option for ICI-MMM.
• Early recognition and aggressive intervention are critical for improving outcomes in ICI-MMM.

Guideline-Based Recommendations

Diagnosis

• Diagnosis based on clinical, laboratory, electrophysiological, and imaging findings; include specific diagnostic criteria.

Management

• Initial treatment with corticosteroids and IVIG; consider eculizumab for refractory cases.

Monitoring & Follow-up

• Close monitoring of clinical symptoms and serological markers.

Risks

• High in-hospital mortality rates associated with ICI-MMM.

Patient & Prescribing Data

Eculizumab (900 mg weekly for four doses) led to marked clinical improvement; include follow-up results.

Clinical Best Practices

• Early recognition and aggressive intervention are critical for improving outcomes in ICI-MMM.
• Consider eculizumab in cases of severe or refractory ICI-MMM.
• Multidisciplinary management involving oncology and neurology is recommended.

Related Resources & Content

• Eculizumab in Myasthenia Gravis
• Immune Checkpoint Inhibitors and Adverse Events
• Complement Inhibition in Myasthenia Gravis