Table 1 Overlap syndrome cases characteristics
| Â | Case 1 | Case 2 | Case 3 | Case 4 |
|---|---|---|---|---|
Oncologic disease | Metastatic renal cell carcinoma | Metastatic prostate carcinoma | Metastatic squamous cell carcinoma | Adenocarcinoma of the lung |
BMI | 25.2 | 31.6 | 20.2 | 25.2 |
ICI | Nivolumab/Ipilimumab | Nivolumab/Ipilimumab | Cemiplimab | Nivolumab/Ipilimumab |
Troponin T, Ref: < 19 ng/L | 620 ng/L | 1383 ng/L | 2,262 ng/L | 565 ng/L |
NT Pro-BNP Ref: < 125 pg/mL | 52 pg/ml | 2446 pg/ml | 827 pg/ml | 27,832 pg/mL |
CK, Ref: < 309 U/L | 499 U/L | 2,206 U/L | 558 U/L | 486 U/L |
CK-MB, Ref: < 10.5 ng/mL | 61.2 ng/mL | 116 ng/mL | 62.6 ng/mL | 131 ng/mL |
Aldolase, Ref: < 7.7 U/L | 10.7 U/L | 10.2 U/L | 43.8 U/L | 9.6 U/L |
ECG | Sinus tachycardia without ischemic changes | New wide QRS morphology | Premature ventricular contractions | Significant for anterolateral ST depression |
Echocardiogram | No wall motion abnormalities, LVEF 55% | No wall motion abnormalities, LVEF 63% | No wall motion abnormalities, LVEF 64% | Global hypokinesis, LVEF 40% |
EMG | No neuromuscular junction dysfunction | Axonal and demyelinating motor and sensory peripheral neuropathy | Signs of myositis | Signs of myositis and Guillain–Barre syndrome |
Heart catheterization | Singe vessel 60% stenosis | Multi vessel disease, 60% stenosis | Multi vessel disease, 60% stenosis | Deferred until stable |
Myocardial biopsy | Leucocytes infiltration | Leucocytes infiltration | Leucocytes infiltration | Refused |
Muscle biopsy | Leucocytes infiltration | Leucocytes infiltration | Not performed | Refused |