Table 1. Case reports of neuromuscular disorder after pembrolizumab administration.

Age/sex reference	Underlying disease	Symptom onset* (weeks)	Symptoms	Diagnosis	CK (U/L)	AChR ab*	Immuno-therapy	Outcome
34/F (our case)	Thymic cancer	8	EOM limitation, ptosis, neck weakness, dyspnea, dysphagia, and hypophonia	MG with myositis	2,125	+	IVIg, IVMP, PLEX, prednisone	Partial recovery
86/F2	Metastatic melanoma	6	EOM limitation, ptosis, proximal limb weakness, fatigue, and dysphonia	Necrotic myositis	1,499	−	IVMP, PLEX	Recovery
69/F3	Metastatic melanoma	9	EOM limitation, ptosis, dyspnea, and general weakness	MG	↑	−	IMVP, PLEX	No significant recovery, died due to brain metastasis
75/M4	Metastatic melanoma, well-controlled MG	5	Ptosis, dyspnea, and neck and proximal limb weakness	Exacerbation of MG	NR	+	IVIg, prednisone	Recovery
59/F5	Metastatic melanoma, well-controlled MG	12	Dyspnea, dysphagia with dysarthria, and general weakness	Exacerbation of MG	NR	−	PLEX, IVIg, prednisone	Recovery
71/F6	Metastatic melanoma	12	EOM limitation, dysphagia, dysarthria, and neck and proximal limb weakness	MG	1,200	−	Prednisone	Recovery, died due to underlying cancer
78/M7	Metastatic melanoma	8	Ptosis, facial weakness, dyspnea, dysphagia, dysarthria, proximal limb weakness, and myalgia	Necrotic myopathy over a NMJ disorder	1,284	−	PLEX, prednisone	No significant recovery, passed away
63/M8	Metastatic melanoma	2	EOM limitation, ptosis, facial weakness, dyspnea, and periorbital edema with erythema	MG with myositis	10,386	+	IVIg, IVMP, PLEX, prednisone	No significant recovery, died
85/F9	Metastatic melanoma	4.5	Diplopia and ptosis	Ocular MG	NR	−	IVIg, prednisone	Recovery

^*After administering pembrolizumab.

AChR ab: acetylcholine-receptor antibody, CK: serum creatine kinase, EOM: extraocular muscle movement, F: female, IVIg: intravenous immunoglobulin, IVMP: intravenous methylprednisolone, M: male, MG: myasthenia gravis, NMJ: neuromuscular junction, NR: not reported, PLEX: plasmapheresis.