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June 20, 2026Immunological MedicineOpen Access

Anti-striated muscle antibody positive anti-PD-1 antibody related myositis and cardiomyositis: an instructive autopsy case report with discussion for trigger of irAE

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Authors

AKAyaka KamadaTohoku Medical and Pharmaceutical UniversityTNTaichi NomuraHokkaido UniversityTKTerufumi KuboSapporo Medical University

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Overview

Randomized trial describes immune-related myositis and myocarditis in a man treated with nivolumab, suggesting complex pathology.

Key Points

  • To investigate the immunopathological features of myositis and myocarditis triggered by immune checkpoint inhibitors.
  • Case report of a 76-year-old man with metastatic renal cell carcinoma receiving nivolumab.
  • Patient exhibited fatigue, elevated creatine kinase, and complete atrioventricular block leading to a fatal outcome.
  • Autopsy analysis included serum antibody tests and spatial analysis using digital pathology.
  • Serum positive for anti-Kv1.4 and anti-titin antibodies; autopsy revealed active immune infiltration.
  • CD8-positive T cells and CD163-positive macrophages were identified in cardiac and skeletal muscle tissue.
  • HLA class I expression was closely associated with infiltrating T cells, indicating a potential inflammatory feedback loop.

Cite This Study

Kamada et al. (2026) studied this question.

synapsesocial.com/papers/6a363172db0793dc1a5384aahttps://doi.org/10.1080/25785826.2026.2692148
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