{"id":"https://openalex.org/W4389728343","doi":"https://doi.org/10.1097/01.ccm.0001000048.26819.a6","title":"467: A CASE OF AVELUMAB-ASSOCIATED MYASTHENIA GRAVIS, MYOSITIS, AND MULTIORGAN FAILURE","display_name":"467: A CASE OF AVELUMAB-ASSOCIATED MYASTHENIA GRAVIS, MYOSITIS, AND MULTIORGAN FAILURE","publication_year":2023,"publication_date":"2023-12-14","ids":{"openalex":"https://openalex.org/W4389728343","doi":"https://doi.org/10.1097/01.ccm.0001000048.26819.a6"},"language":"en","primary_location":{"id":"doi:10.1097/01.ccm.0001000048.26819.a6","doi":"https://doi.org/10.1097/01.ccm.0001000048.26819.a6","is_oa":false,"landing_page_url":"https://doi.org/10.1097/01.ccm.0001000048.26819.a6","pdf_url":null,"source":{"id":"https://openalex.org/S108732581","display_name":"Critical Care Medicine","issn_l":"0090-3493","issn":["0090-3493","1530-0293"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical Care Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5087776729","display_name":"Sreejith Pillai","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2802326326","display_name":"The University of Texas Rio Grande Valley","ror":"https://ror.org/02p5xjf12","country_code":"US","type":"education","lineage":["https://openalex.org/I2802326326"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sreejith Pillai","raw_affiliation_strings":["University of Texas Rio Grande Valley"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Texas Rio Grande Valley","institution_ids":["https://openalex.org/I2802326326"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5101674128","display_name":"Pooja Patel","orcid":"https://orcid.org/0000-0002-4190-4909","observed_orcids":["https://orcid.org/0000-0002-4190-4909"]},"institutions":[{"id":"https://openalex.org/I4210109219","display_name":"Mercy Catholic Medical Center","ror":"https://ror.org/01k05jx47","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1314179348","https://openalex.org/I4210109219"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Pooja Patel","raw_affiliation_strings":["Mercy Catholic Medical Center, Folcroft, PA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mercy Catholic Medical Center, Folcroft, PA","institution_ids":["https://openalex.org/I4210109219"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5092988496","display_name":"Sujith Jagadeesanpillai","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I160354086","display_name":"Guangxi Medical University","ror":"https://ror.org/03dveyr97","country_code":"CN","type":"education","lineage":["https://openalex.org/I160354086"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Sujith Jagadeesanpillai","raw_affiliation_strings":["Guangxi Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Guangxi Medical University","institution_ids":["https://openalex.org/I160354086"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5077556772","display_name":"Celin Rajan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2802326326","display_name":"The University of Texas Rio Grande Valley","ror":"https://ror.org/02p5xjf12","country_code":"US","type":"education","lineage":["https://openalex.org/I2802326326"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Celin Rajan","raw_affiliation_strings":["University of Texas Rio Grande Valley"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Texas Rio Grande Valley","institution_ids":["https://openalex.org/I2802326326"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5114109133","display_name":"Jian Cruz","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2802326326","display_name":"The University of Texas Rio Grande Valley","ror":"https://ror.org/02p5xjf12","country_code":"US","type":"education","lineage":["https://openalex.org/I2802326326"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jian Cruz","raw_affiliation_strings":["University of Texas Rio Grande Valley, Weslaco, TX"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Texas Rio Grande Valley, Weslaco, TX","institution_ids":["https://openalex.org/I2802326326"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5004275609","display_name":"Juan Fernando Ort\u00edz","orcid":"https://orcid.org/0000-0001-7512-6140","observed_orcids":["https://orcid.org/0000-0001-7512-6140"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Juan Ortiz","raw_affiliation_strings":["Pulmonary And Sleep Center Of The Valley"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pulmonary And Sleep Center Of The Valley","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.2406,"has_fulltext":false,"cited_by_count":2,"citation_normalized_percentile":{"value":0.47422543,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":95},"biblio":{"volume":"52","issue":"1","first_page":"S207","last_page":"S207"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10158","display_name":"Cancer Immunotherapy and Biomarkers","score":0.864300012588501,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10158","display_name":"Cancer Immunotherapy and Biomarkers","score":0.864300012588501,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11271","display_name":"Myasthenia Gravis and Thymoma","score":0.11420000344514847,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11724","display_name":"Inflammatory Myopathies and Dermatomyositis","score":0.008200000040233135,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/avelumab","display_name":"avelumab","score":0.9879999756813049},{"id":"https://openalex.org/keywords/myasthenia-gravis","display_name":"myasthenia gravis","score":0.921999990940094},{"id":"https://openalex.org/keywords/inflammatory-myopathies","display_name":"myositis","score":0.9179999828338623},{"id":"https://openalex.org/keywords/multiple-organ-failure","display_name":"multiple organ failure","score":0.9419999718666077},{"id":"https://openalex.org/keywords/immune-checkpoint-inhibitors","display_name":"immune checkpoint inhibitors","score":0.9190000295639038},{"id":"https://openalex.org/keywords/immune-related-adverse-events","display_name":"immune-related adverse events","score":0.6669999957084656},{"id":"https://openalex.org/keywords/urothelial-carcinoma","display_name":"urothelial carcinoma","score":0.8159999847412109},{"id":"https://openalex.org/keywords/renal-pelvis-cancer","display_name":"renal pelvis cancer","score":0.7200000286102295},{"id":"https://openalex.org/keywords/acetylcholine-receptor-antibodies","display_name":"acetylcholine receptor antibodies","score":0.7580000162124634},{"id":"https://openalex.org/keywords/dysphagia","display_name":"dysphagia","score":0.6759999990463257},{"id":"https://openalex.org/keywords/ptosis","display_name":"ptosis","score":0.7149999737739563},{"id":"https://openalex.org/keywords/respiratory-failure","display_name":"respiratory failure","score":0.671999990940094},{"id":"https://openalex.org/keywords/intravenous-immunoglobulin","display_name":"intravenous immunoglobulin","score":0.8659999966621399},{"id":"https://openalex.org/keywords/plasmapheresis","display_name":"plasmapheresis","score":0.9120000004768372},{"id":"https://openalex.org/keywords/methylprednisolone","display_name":"methylprednisolone","score":0.828000009059906},{"id":"https://openalex.org/keywords/pyridostigmine","display_name":"pyridostigmine","score":0.9670000076293945}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9496498703956604},{"id":"https://openalex.org/C2778105408","wikidata":"https://www.wikidata.org/wiki/Q8285","display_name":"Myasthenia gravis","level":2,"score":0.903618574142456},{"id":"https://openalex.org/C2781232998","wikidata":"https://www.wikidata.org/wiki/Q1433212","display_name":"Myositis","level":2,"score":0.675447940826416},{"id":"https://openalex.org/C2911084887","wikidata":"https://www.wikidata.org/wiki/Q1193870","display_name":"Multiorgan failure","level":2,"score":0.6054726243019104},{"id":"https://openalex.org/C16005928","wikidata":"https://www.wikidata.org/wiki/Q171171","display_name":"Dermatology","level":1,"score":0.3358137607574463},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.3248351812362671},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.2420680820941925},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.22224697470664978}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1097/01.ccm.0001000048.26819.a6","doi":"https://doi.org/10.1097/01.ccm.0001000048.26819.a6","is_oa":false,"landing_page_url":"https://doi.org/10.1097/01.ccm.0001000048.26819.a6","pdf_url":null,"source":{"id":"https://openalex.org/S108732581","display_name":"Critical Care Medicine","issn_l":"0090-3493","issn":["0090-3493","1530-0293"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical Care Medicine","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2939736334","https://openalex.org/W2970537178","https://openalex.org/W2985911458","https://openalex.org/W4409823005","https://openalex.org/W4413795744","https://openalex.org/W2891525212","https://openalex.org/W4403206607","https://openalex.org/W2805577461","https://openalex.org/W3208504097","https://openalex.org/W4390952559"],"abstract_inverted_index":{"Introduction:":[0],"The":[1,147],"use":[2],"of":[3,38,54,58,114,120,166,172,187,231,250],"checkpoint":[4,23],"inhibitors":[5,24],"against":[6],"programmed":[7],"death":[8],"ligand-1,":[9],"and":[10,44,83,99,101,133,154,160,176,207,236,260,281,302,305],"cytotoxic":[11],"T-lymphocytes-":[12],"associated":[13,29,40],"protein-4":[14],"has":[15],"become":[16],"widespread":[17],"in":[18,263,297],"clinical":[19,264],"practice1[1].":[20],"These":[21],"immune":[22],"such":[25],"as":[26],"Avelumab":[27,39,66],"are":[28],"with":[30,51,81,112,244,300],"various":[31],"adverse":[32,290],"effects.":[33],"We":[34],"present":[35],"a":[36,52,248,271,285],"case":[37],"Myasthenia":[41,233],"Graves,":[42],"myositis,":[43,235,280],"multi-organ":[45,237,282],"failure":[46,224,238,283],"Description:":[47],"A":[48,229],"68-year-old":[49],"man":[50],"history":[53],"high-grade":[55],"Urothelial":[56],"carcinoma":[57],"the":[59,79,167,173,188],"renal":[60],"pelvis":[61],"was":[62,142,196,214,239,242,267],"initiated":[63],"on":[64],"maintenance":[65],"6":[67],"weeks":[68],"after":[69],"successful":[70],"resection":[71],"followed":[72],"by":[73],"adjunct":[74],"chemotherapy.":[75],"He":[76,266],"presented":[77],"to":[78,97,216,221,270,309],"hospital":[80],"dysphagia":[82,96,301],"bilateral":[84,93],"ptosis":[85],"for":[86,198,274],"4":[87],"days.":[88],"On":[89],"physical":[90],"examination,":[91],"dysarthria,":[92],"bulbar":[94,303],"weakness,":[95],"solids":[98],"liquids,":[100],"generalized":[102],"weakness":[103],"were":[104,162],"noted.":[105],"Laboratory":[106],"results":[107],"revealed":[108,151,169,179],"creatinine":[109,140],"1.7":[110],"mg/dl":[111,132],"eGFR":[113],"43":[115],"ml/min/1.73":[116],"m2,":[117],"elevated":[118,152],"levels":[119,156],"aspartate":[121],"aminotransferase":[122],"297":[123],"U/L,":[124,128],"alanine":[125],"transaminase":[126],"222":[127],"C-Reactive":[129],"protein":[130,153],"1.4":[131],"erythrocyte":[134],"sedimentation":[135],"rate":[136],"35":[137],"mm/hr.":[138],"Notably,":[139],"kinase":[141],"increased":[143],"at":[144,204,211,247],"8347":[145],"U/L.":[146],"patient\u2019s":[148],"CSF":[149],"analysis":[150],"glucose":[155],"but":[157,287],"molecular":[158],"panel":[159],"cultures":[161],"unremarkable.":[163],"Computed":[164],"tomography":[165],"chest":[168],"an":[170,177],"eventration":[171],"left":[174],"hemidiaphragm":[175],"echocardiogram":[178],"normal":[180],"overall":[181],"heart":[182],"function.":[183],"Magnetic":[184],"resonance":[185],"imaging":[186],"brain":[189],"showed":[190],"no":[191],"acute":[192],"abnormalities.":[193],"Autoimmune":[194],"workup":[195],"positive":[197,226],"acetylcholinesterase":[199],"receptor":[200],"(AchR)":[201],"binding":[202],"antibody":[203],"1.30":[205],"nmol/L":[206],"AchR":[208],"blocking":[209],"antibodies":[210],"40%.":[212],"Patient":[213,241],"transferred":[215,269],"intensive":[217],"care":[218],"unit":[219],"due":[220],"worsening":[222],"respiratory":[223],"requiring":[225],"pressure":[227],"ventilation.":[228],"diagnosis":[230,296],"Avelumab-associated":[232,277],"Gravis,":[234],"made.":[240],"managed":[243],"intravenous":[245],"immunoglobulin":[246],"dose":[249],"2":[251],"gm/kg":[252],"divided":[253],"over":[254],"four":[255],"days,":[256],"Methylprednisolone":[257],"40":[258],"mg,":[259],"pyridostigmine":[261],"resulting":[262],"improvement.":[265],"later":[268],"sister":[272],"facility":[273],"plasmapheresis.":[275],"Discussion:":[276],"myasthenia":[278],"gravis,":[279],"is":[284],"rare":[286],"life-threatening":[288],"immune-mediated":[289],"event.":[291],"Clinicians":[292],"should":[293],"suspect":[294],"this":[295],"patients":[298],"presenting":[299],"symptoms,":[304],"initiate":[306],"timely":[307],"treatment":[308],"prevent":[310],"fatal":[311],"deterioration.":[312]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2024,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2023-12-15T00:00:00"}
