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Print ISSN: 1792-0981 Online ISSN: 1792-1015
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October-2025 Volume 30 Issue 4

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Efgartigimod for immune checkpoint inhibitor induced polyradiculoneuropathy and cardiomyopathy: A case report

  • Authors:
    • Siqi Dong
    • Zhangyang Wang
    • Qin Wang
    • Zhen Huang
    • Jihong Dong
    • Shuai Wu
  • View Affiliations / Copyright

    Affiliations: Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
    Copyright: © Dong et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 4.0].
  • Article Number: 197
    |
    Published online on: August 13, 2025
       https://doi.org/10.3892/etm.2025.12947
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Abstract

Immune checkpoint inhibitors (ICIs) play a crucial role in cancer therapy by enhancing anti‑tumor immune responses. However, they may also induce immune‑related adverse events (irAEs) such as polyradiculoneuropathy (PRN) and cardiomyopathy, which, although rare, can be life‑threatening. Traditional treatments, including corticosteroids and intravenous immunoglobulin (IVIG), often show limited efficacy, underscoring the need for alternative therapeutic strategies. The present study reported the case of a 63‑year‑old female diagnosed with pancreatic ductal adenocarcinoma who developed profound neurological and cardiac dysfunction, including bilateral ptosis, limb weakness and dysphagia, following chemotherapy and ICI therapy. Initial immunotherapy with IVIG and corticosteroids resulted in only partial clinical improvement. Subsequent administration of efgartigimod induced significant neurological recovery, with normalization of both the Inflammatory Neuropathy Cause and Treatment disability score and Activities of Daily Living scale following four weekly doses. Clinical improvement was accompanied by reductions in both cytokine and immunoglobulin levels. This case illustrates the therapeutic potential of efgartigimod in managing ICI‑induced PRN and cardiomyopathy, particularly in patients refractory to standard therapies. The observed improvements suggest that antibody‑mediated pathways may play a pivotal role in the pathogenesis of irAEs. Further studies are warranted to confirm the efficacy and safety of efgartigimod in alleviating ICI‑related irAEs in broader clinical settings.
View Figures

Figure 1

Longitudinal profiles of disease
progression and therapeutic interventions. (A) Clinical timeline
showing disease diagnosis and treatment milestones. (B) Clinical
manifestation scores: ADL (left Y-axis); INCAT (right Y-axis). (C)
Serum cytokine dynamics: TNF-α, IL-1β, IL-6 and IL-10 (left
Y-axis); sIL-2R (right Y-axis). (D) Immunoglobulin kinetics: IgG,
IgA and IgM (left Y-axis); IgE (right Y-axis). AG chemotherapy,
chemotherapy with the cytarabine plus gemcitabine; EGF,
efgartigimod; ADL, Activities of Daily Living; INCAT, Inflammatory
Neuropathy Cause and Treatment; sIL-2R, soluble IL-2 receptor.
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Copy and paste a formatted citation
Spandidos Publications style
Dong S, Wang Z, Wang Q, Huang Z, Dong J and Wu S: Efgartigimod for immune checkpoint inhibitor induced polyradiculoneuropathy and cardiomyopathy: A case report. Exp Ther Med 30: 197, 2025.
APA
Dong, S., Wang, Z., Wang, Q., Huang, Z., Dong, J., & Wu, S. (2025). Efgartigimod for immune checkpoint inhibitor induced polyradiculoneuropathy and cardiomyopathy: A case report. Experimental and Therapeutic Medicine, 30, 197. https://doi.org/10.3892/etm.2025.12947
MLA
Dong, S., Wang, Z., Wang, Q., Huang, Z., Dong, J., Wu, S."Efgartigimod for immune checkpoint inhibitor induced polyradiculoneuropathy and cardiomyopathy: A case report". Experimental and Therapeutic Medicine 30.4 (2025): 197.
Chicago
Dong, S., Wang, Z., Wang, Q., Huang, Z., Dong, J., Wu, S."Efgartigimod for immune checkpoint inhibitor induced polyradiculoneuropathy and cardiomyopathy: A case report". Experimental and Therapeutic Medicine 30, no. 4 (2025): 197. https://doi.org/10.3892/etm.2025.12947
Copy and paste a formatted citation
x
Spandidos Publications style
Dong S, Wang Z, Wang Q, Huang Z, Dong J and Wu S: Efgartigimod for immune checkpoint inhibitor induced polyradiculoneuropathy and cardiomyopathy: A case report. Exp Ther Med 30: 197, 2025.
APA
Dong, S., Wang, Z., Wang, Q., Huang, Z., Dong, J., & Wu, S. (2025). Efgartigimod for immune checkpoint inhibitor induced polyradiculoneuropathy and cardiomyopathy: A case report. Experimental and Therapeutic Medicine, 30, 197. https://doi.org/10.3892/etm.2025.12947
MLA
Dong, S., Wang, Z., Wang, Q., Huang, Z., Dong, J., Wu, S."Efgartigimod for immune checkpoint inhibitor induced polyradiculoneuropathy and cardiomyopathy: A case report". Experimental and Therapeutic Medicine 30.4 (2025): 197.
Chicago
Dong, S., Wang, Z., Wang, Q., Huang, Z., Dong, J., Wu, S."Efgartigimod for immune checkpoint inhibitor induced polyradiculoneuropathy and cardiomyopathy: A case report". Experimental and Therapeutic Medicine 30, no. 4 (2025): 197. https://doi.org/10.3892/etm.2025.12947
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