Antonio Lauletta: Distinguishing Sporadic and ICI-Related MG-Myositis Overlap
Antonio Lauletta, Neurologist at Sapienza University of Rome, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Neurology Journals, adding:
“Delighted to have attended my first International Congress on Neuromuscular Diseases – ICNMD, held this year in Florence, and honoured to receive the Best Poster Award in the Neuromuscular Junction topic for our recently published multicentre study in Neurology comparing sporadic and immune checkpoint inhibitor-related myasthenia gravis–inflammatory myopathy overlap syndrome (MG-IM).
Although they share some clinical and serological features, including anti-AChR and anti-striational antibody positivity, our findings suggest that these are distinct conditions. Sporadic MG-IM is typically thymoma-associated, with a variable clinical presentation ranging from distal weakness to generalized involvement, and follows a chronic, relapsing course with generally favourable outcomes.
In contrast, ICI-related MG-IM has an acute, severe and probably monophasic course, with substantial early mortality largely driven by cardiac and respiratory involvement.
Importantly, concomitant MG may be overdiagnosed in ICI-related cases.
Ptosis and diplopia as well as bulbar symptoms and respiratory weakness may reflect direct muscle involvement from myositis, while the presence of anti-AChR antibodies may represent an epiphenomenon rather than a pathogenic driver of neuromuscular junction dysfunction.
Recognising this distinction is particularly important, especially in patients with concomitant myocarditis, since a suspected diagnosis of MG may delay prompt initiation of high-dose corticosteroids and appropriate management.
Grateful to all collaborators and mentors who made this work possible.
Looking forward to ICNMD 2027 in Chiba!”
Title: Comparative Study of Sporadic and Immune Checkpoint Inhibitor–Related Forms of Myasthenia Gravis-Myositis Overlap Syndrome
Authors: Antonio Lauletta, Elena Rossini, Francesca Beretta, Valentina Damato, Simone Rossi, Raffaele Iorio, Enrico Marchioni, Antonio Petrucci, Alberto Vogrig, Carmela Romano, Laura Tufano, Luca Leonardi, Stefania Morino, Francesca Forcina, Demetrio Marando, Valentina Vera, Silvia Falso, Sofia Marini, Gregorio Spagni, Stefano Masciocchi, Paola Bini, Antonio Lotti, Matteo Garibaldi, Laura Fionda
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