A 35-year-old female patient with advanced lung cancer was treated with paclitaxel (albumin-bound) and carboplatin chemotherapy, combined with tislelizumab immunotherapy for one cycle. After 6 days of treatment, the patient developed sagging of the right eyelid compared to the left side, mild morning and heavy evening, systemic muscle soreness, abnormal transaminases and myocardial enzymes, and abnormal electrocardiogram. It is suspected that there may be a correlation between tislelizumab and myasthenia gravis or related myositis. After admission, patients were treated with methylprednisolone, intravenous immunoglobulin, plasma exchange, mycophenolate mofetil, temporary pacemaker installation, and tracheal intubation. After more than a month of treatment, the patient's indicators decreased, but the patient became unconscious, the patient’s family requested discharge. The association between the multisystem adverse reactions and tislelizumab was evaluated using the Naranjo's Assessment Scale, the correlation score was 7 and evaluated as probably relevant. It is suggested that when using tislelizumab in clinical practice, risk factor assessment and medication monitoring should be strengthened to ensure drug safety.

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