1例53岁女性患者于肝内胆管癌术后20个月给予纳武利尤单抗注射液140 mg静脉滴注、1次/d，第1、20天。第2次应用该药后第3天，患者出现双下肢乏力；第14天乏力加重，出现视物模糊、上眼睑下垂、胸闷气促伴心悸；第24天出现胡言乱语，发展为呼之不应。给予气管插管机械通气及对症支持治疗后患者神志恢复。诊断为药源性重症肌无力危象，合并心力衰竭、呼吸衰竭。给予激素、人免疫球蛋白治疗19 d后，患者眼睑下垂、心悸症状明显好转，但呼吸衰竭无明显好转，无法脱机自主呼吸。“,”A 53-year-old female patient received an IV infusion of nivolumab 140 mg once daily 20 months after the operation of intrahepatic cholangiocarcinomas. The drug was used on the first and 20th days of the treatment. On day 3 of the second injection of the drug, the patient developed weakness in both lower limbs, which was aggravated on day 14, accompanied by symptoms such as blurred vision, ptosis, chest tightness, short of breath, and palpitation. On day 24 of the second injection of the drug, her condition became worse, the patient raved, then developed no response to voice stimuli. The patient′s consciousness recovered after mechanical ventilation with nasotracheal intubation and symptomatic and supportive treatments. The patient was diagnosed as drug-induced myasthenia gravis crisis combined with heart failure and respiratory failure. After 19 days of treatments with hormone and human immune globulin, her ptosis and palpitation were improved. However, her respiratory failure was not improved. She was unable to breathe spontaneously.