The Drug-Induced Respiratory Disease Website

Pembrolizumab

Myasthenia gravis - Myasthenic-like syndrome

May ccause ARF. See also under respiratory muscle weakness

Publications

March KL, Samarin MJ, Sodhi A, Owens RE

Pembrolizumab-induced myasthenia gravis: A fatal case report.

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 2018 Mar;24;146-149 — 2018 Mar — 146-149

Lau KH, Kumar A, Yang IH, Nowak RJ

Exacerbation of myasthenia gravis in a patient with melanoma treated with pembrolizumab.

Muscle & nerve 2016 06;54;157-61 — 2016 06 — 157-61

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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